title: Sialylation of Campylobacter jejuni lipo-oligosaccharides is associated with severe gastro-enteritis and reactive arthritis.
abstract: We used various genotyping methods to identify bacterial genetic markers for development of arthritic symptoms following Campylobacter enteritis. We genotyped a collection of population derived Campylobacter strains, with detailed information on clinical characteristics, including arthritic symptoms. Besides using whole genome screening methods, we focused on the lipo-oligosaccharide (LOS) gene locus in which marker genes for developing post-Campylobacter neurological disease are present. Patients with arthritic symptoms were more frequently infected with Campylobacter jejuni strains with a class A LOS locus. We also found that patients who were infected with a C. jejuni strain containing sialic acid-positive LOS (class A, B or C) more frequently had bloody diarrhoea and a longer duration of symptoms. Furthermore, the IgM antibody response against Campylobacter was stronger in patients with a sialic acid containing LOS. Ganglioside auto-antibodies were observed in a small number of patients following infection with a class C strain. We conclude that sialylation of C. jejuni LOS is not only a risk factor for development of post-infectious symptoms, but is also associated with increased severity of enteric disease.
authors.affiliation: Unit of Gastrointestinal Infections, Statens Serum Institute, DK 2300 Copenhagen S, Denmark.
authors.forename: Ninell P
authors.initials: NP
authors.lastname: Mortensen
authors.forename: Mark L
authors.initials: ML
authors.lastname: Kuijf
authors.forename: C Wim
authors.initials: CW
authors.lastname: Ang
authors.forename: Peter
authors.initials: P
authors.lastname: Schiellerup
authors.forename: Karen A
authors.initials: KA
authors.lastname: Krogfelt
authors.forename: Bart C
authors.initials: BC
authors.lastname: Jacobs
authors.forename: Alex
authors.initials: A
authors.lastname: van Belkum
authors.forename: Hubert Ph
authors.initials: HP
authors.lastname: Endtz
authors.forename: Mathijs P
authors.initials: MP
authors.lastname: Bergman
mesh_terms: D016918:Arthritis, Reactive / Q000382:microbiology / Q000473:pathology*; D002169:Campylobacter Infections / Q000382:microbiology / Q000473:pathology*; D016123:Campylobacter jejuni / Q000737:chemistry* / Q000472:pathogenicity*; D004751:Enteritis / Q000382:microbiology / Q000473:pathology*; D005260:Female; D006801:Humans; D008070:Lipopolysaccharides / Q000378:metabolism*; D008297:Male; D019158:N-Acetylneuraminic Acid / Q000378:metabolism*; D012720:Severity of Illness Index
chemical_list: D008070:Lipopolysaccharides; C023023:lipid-linked oligosaccharides; D019158:N-Acetylneuraminic Acid