Reactive Arthritis

Abstract

Reactive arthritis (ReA) is an immune-mediated seronegative arthritis that belongs to the group of spondyloarthropathies and develops after a gastrointestinal or genitourinary system infection. The condition is considered to be characterized by a triad of symptoms (conjunctivitis, arthritis and urethritis) although a constellation of other manifestations may also be present. ReA is characterized by psoriasiform dermatological manifestations that may resemble those of pustular psoriasis and, similar to guttate psoriasis, is a post-infectious entity. Also, the articular manifestations of the disorder are similar to those of psoriatic arthritis and both conditions show a correlation with HLA-B27. These facts have led several authors to suggest that there is a connection between ReA and psoriasis, listing ReA among the disorders related to psoriasis. However, the pathogenetic mechanism behind the condition is complex and poorly understood. Bacterial antigenicity, the type of host response (i.e. Th1/Th2 imbalance) and various genetic factors (i.e. HLA-B27 etc.) play an important role in the development of the disorder. It is unknown whether all the aforementioned factors are part of a mechanism that could be similar to, or share basic aspects with known psoriasis pathogenesis mechanisms.

Bilateral interstitial keratitis with anterior stromal infiltrates associated with reactive arthritis

“…Reactive arthritis, formerly Reiter’s syndrome, is a rare autoimmune seronegative spondyloarthropathy which typically develops following an infection of the gastrointestinal or genitourinary system a few weeks prior 1. However, it may be triggered by other pathogens associated with respiratory tract and other infections 1.…”

“…However, it may be triggered by other pathogens associated with respiratory tract and other infections 1. Reactive arthritis is more common in young adult males 1…”

“…While the classic triad of urethritis, conjunctivitis and arthritis is found in a third of patients,1 other findings may manifest in the eye, genitourinary system and elsewhere, including the kidney and heart 1. Interestingly, mucocutaneous lesions are present in up to 50% of the patients 1.…”

Reactive arthritis imunopathogenesis

“…Відомо, що реактивний артрит (РеА) є одним із найпоширеніших захворювань сугло-бів [1][2][3][4][5][6]. Протягом останніх років спостерігають зростання чисельності хворих із цією патологією.…”

“…Характерною його особливістю є наяв-ність хронічного запального процесу в суглобах, де спостерігають активацію мононуклеарних клітин (макрофагів, лімфоцитів, плазматичних клітин), а також фібробластів, які сприяють про-ліферації сполучної тканини [8,9,11,15]. Авто-антитіла до компонентів синовіальної оболонки разом із активованими Т лімфоцитами посилю-ють запальну реакцію, яка спричиняє прогресу-юче ураження суглобових тканин [8][9][10]12], як і активні форми кисню та азоту, що утворюються в місці запалення [6,10].…”