Objective. To investigate the hypothesis that whole bacteria might be found in the joints of patients with Chlamydia-associated reactive arthritis.Methods. The presence of 2 plasmid-and 2 chromosome-specific sequences of Chlamydia DNA was investigated by amplification with the polymerase chain reaction, in synovial fluid (SF) samples from 71 patients with various arthropathies.Results. Chlamydia DNA was found in SF samples from 22 patients.Conclusion. Whole chlamydiae are likely present in the SF of patients with Chlamydia-associated reactive arthritis.Reactive arthritis may occur following an infection of the urogenital tract caused by Chlamydia. The presence in joint material of chlamydial antigens, suggestive of elementary and reticulate bodies, has been reported (1-6). An important question is whether whole chlamydiae, or only fragments, are present in the joint. Bacterial remnants, in contrast to live bacteria, would not contain appreciable amounts of undegraded nucleic acids.Studies investigating for the presence of Chlamydia nucleic acids have had variable results. Initial attempts to use the polymerase chain reaction (PCR) (7) to detect Chlamydia DNA were unsuccessful.
In a 2-yr prospective follow-up study of patients presenting clinically with possible reactive arthritis (ReA), 17 (9%) of the patients turned out to have acute sarcoid arthritis (SA). The number of new cases of SA per year was 2.9/100,000 persons in the city of Oslo between 18 and 60 yr of age. The onset of SA clustered in the spring. All the SA patients presented with bilateral ankle joint involvement and bilateral hilar lymphadenopathy, and ten (59%) presented with the triad of erythema nodosum, arthritis and lung involvement. A prospective follow-up after 104 weeks showed complete remission of arthritis in all 17 cases of SA. The total duration of arthritis [median (range)] was 11 (2-107) weeks. Erythema nodosum was mild and transient in all cases. At week 104, the lung and hilar manifestations had resolved. We conclude that the outcome of SA appeared favourable. Bilateral ankle joint involvement, erythema nodosum and bilateral hilar lymphadenopathy found at the routine chest X-ray examination are important clues for the diagnosis of SA.
Objective. Extensive changes in articular cartilage metabolism occur during the acute phase of reactive arthritis, as indicated by altered release of cartilage macromolecules into synovial fluid (SF) demonstrated immunochemically. Nevertheless, permanent cartilage lesions are rare in this disease. To monitor specific events during the evolution of reactive arthritis, we investigated the content of cartilage macromolecules in sequentially obtained SF samples from 22 patients.Methods. Two groups of proteoglycan epitopes, the glycosaminoglycan-rich region of aggrecan (referred to as proteoglycan) and its hyaluronan-binding region (HABr), as well as one matrix protein, cartilage oligo- Results. SF proteoglycan concentrations, which were initially elevated, decreased significantly with prolonged arthritis, whereas COMP levels changed less markedly and levels of HABr remained stable. There was a positive correlation between SF and serum concentrations of COMP in samples obtained during the early phase of the disease.Conclusion. Cartilage involvement in reactive arthritis is transient, in contrast to findings in rheumatoid arthritis. Reactive arthritis should therefore be a suitable model for studies of repair processes in cartilage, which will facilitate understanding of the pathophysiology of cartilage involvement in arthritis.Reactive arthritis is characterized by the acute onset of arthritis in one or a few joints following an infection, most often of the urinary or gastrointestinal tract (1). Viable organisms are not found in the joint. In the majority of cases the disease is self-limited, and radiographically visible joint damage rarely develops. Nevertheless, previous work has indicated that articular cartilage is involved in the disease process (2).Major constituents of the organic matrix of articular cartilage are type I1 collagen fibers and the cartilage-specific, large aggregating proteoglycan, aggrecan (3). The function of cartilage depends on both the highly polyanionic proteoglycan aggregates and the collagen fibers. A number of other matrix constituents have essential roles in regulating the assembly of the matrix and in participating in interactions necessary for the integrity of the tissue. One such noncol-
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.