Chlamydia-induced reactive arthritis: Hidden in plain sight?

Carter, John D.; Inman, Robert D.

doi:10.1016/j.berh.2011.05.001

Cited by 29 publications

(30 citation statements)

References 82 publications

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“…In cases of chronic infection, C. trachomatis shows an unusual profile of gene expression that includes the attenuation and up regulation of certain set of genes. [5,8]. A recent study confirmed the presence of metabolically active chlamydiae during the remitting phase in synovial tissues from patients with chronic C. trachomatisinduced ReA [9].…”

Section: Introductionmentioning

confidence: 71%

Diagnosis of Chlamydia trachomatis in patients with reactive arthritis and undifferentiated spondyloarthropathy

Prabhash

Bhakuni

Rastogi

2014

J Infect Dev Ctries

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Introduction: There is a paucity of information on the frequency of Chlamydia trachomatis-induced reactive arthritis (ReA) and undifferentiated spondyloarthropathy (uSpA) in India. In this study, arthritic patients suffering from ReA, uSpA, and rheumatoid arthritis (RA) were screened to investigate the presence of C. trachomatis infection in the synovial fluid (SF) or serum by molecular and nonmolecular methods. Methodology: A total of 76 arthritic patients with ReA (n = 16) and uSpA (n = 22) composed the study group while those with RA (n = 38) served as controls. The detection of C. trachomatis DNA was done by semi-nested PCR (snPCR) and nested PCR (nPCR) targeting two different genes of C. trachomatis, namely major outer membrane protein and plasmid, respectively. The presence of serum or SF immunoglobulin IgG and IgA antibodies against C. trachomatis was studied by commercial enzyme-linked immunosorbent assay kits. Results: The SF from 9 of 38 (23.6%) patients (5 with ReA and 4 with uSpA) was positive for at least one C. trachomatis DNA by snPCR or nPCR in comparison to RA (1/38 [2.6%]; p value < 0.05). There was no correlation between the snPCR or nPCR and the serological results of patients with ReA or uSpA. Conclusions: As molecular diagnostic techniques established intra-articular C. trachomatis infection among this group of seronegative spondyloarthropathies in India, these findings should be viewed with concern, and snPCR or nPCR should be considered for a more reliable diagnosis.

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Section: Introductionmentioning

confidence: 71%

Diagnosis of Chlamydia trachomatis in patients with reactive arthritis and undifferentiated spondyloarthropathy

Prabhash

Bhakuni

Rastogi

2014

J Infect Dev Ctries

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“…In ReA other than CiA, the triggering organism is absent from affected joints and pathogenesis is thought to occur largely based on autoimmune factors initiated by distal or resolved infection. However, viable C. trachomatis and/or C. pneumoniae have been demonstrated in affected joints by both electron microscopy and PCR [85]. This suggests that, although host autoimmunity might contribute to pathogenicity, the immune response to an ongoing joint infection may also affect disease pathogenesis.…”

Section: Chlamydia-induced Arthritismentioning

confidence: 93%

“…Early studies reported that up to 80% of ReA cases were HLA-B27 positive, while more recent studies indicate that 30% to 50% of all ReA cases are associated with the allele. Thus, HLA-B27 is currently thought to more accurately represent a risk factor for progression to chronic disease and/or increased disease severity in ReA, rather than a risk factor for ReA susceptibility [85]. In ReA other than CiA, the triggering organism is absent from affected joints and pathogenesis is thought to occur largely based on autoimmune factors initiated by distal or resolved infection.…”

Section: Chlamydia-induced Arthritismentioning

confidence: 99%

“…Currently, however, no national or international guidelines exist for diagnosis or classification of ReA, and incidence and prevalence of ReA and CiA remain unclear. The Office of Rare Diseases Research of the National Institutes of Health categorizes ReA as rare, affecting less than 200,000 individuals in the United States (USA) [85]. Notably, with up to 80% of Chlamydia infections, and up to 90% of C. pneumoniae infections specifically, expected to be asymptomatic [84•,85], it is likely ReA and CiA are underdiagnosed.…”

Section: Chlamydia-induced Arthritismentioning

confidence: 99%

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Chronic Chlamydial Diseases: From Atherosclerosis to Urogenital Infections

Leonard

Borel

2014

Curr Clin Micro Rpt

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Chlamydiae cause a wide range of diseases in human and animal hosts. Chlamydia pneumoniae and Chlamydia trachomatis are important human pathogens with worldwide distribution that produce significant morbidity. Acute infections with C. pneumoniae cause respiratory tract infections, while chronic infection has been linked to chronic bronchitis, asthma and atherosclerosis. Ocular serovars of C. trachomatis induce trachoma, the leading cause of infectious blindness worldwide. C. trachomatis is the most common bacterial cause of sexually transmitted diseases (STDs) worldwide. Acute infections with genital serovars of C. trachomatis remain clinically silent in most women, but can progress to upper genital tract infection leading to pelvic inflammatory disease (PID), infertility and ectopic pregnancy. Chlamydiainduced, reactive arthritis can develop as a late-term condition after genital C. trachomatis or respiratory C. pneumoniae infection. In this review, we address recent information on pathogenesis, immune response, diagnosis and treatment of chronic diseases induced by C. trachomatis and C. pneumoniae. Abstract:Chlamydiae cause a wide range of diseases in human and animal hosts. Chlamydia pneumoniae and Chlamydia trachomatis are important human pathogens with worldwide distribution that produce significant morbidity. Acute infections with C. pneumoniae cause respiratory tract infections, while chronic infection has been linked to chronic bronchitis, asthma and atherosclerosis. Ocular serovars of C. trachomatis induce trachoma, the leading cause of blindness worldwide. C. trachomatis is the most common bacterial cause of sexually-transmitted diseases (STDs) worldwide. Acute infections with genital serovars of C. trachomatis remain clinically silent in most women but can progress to upper genital tract infection leading to pelvic inflammatory disease (PID), infertility and ectopic pregnancy. Chlamydia-induced, reactive arthritis can develop as a late-term condition after genital C. trachomatis or respiratory C. pneumoniae infection. In this review we address recent information on pathogenesis, immune

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“…To wskazuje, że serotypy powodujące zapalenie oczu (trachoma) rozsiewają się łatwiej, a ich lokalizacja w stawie indukuje zapalenie. Te obserwacje mogą również tłumaczyć, dlaczego u wielu chorych na ReZS współwystępują choroby oczu (zapalenie błony naczyniowej oka czy spojówek) [15].…”

Section: Zakażenia Bakteryjneunclassified

New aspects of spondyloarthritis pathogenesis. Part II – environmental factors, microbiome disturbances, extra-articular symptoms

Kontny¹

2014

Reumatologia

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Spondyloartropatie zapalne (SpA) to grupa chorób o podobnych cechach klinicznych i uwarunkowaniach genetycznych. Zakażenia bakteryjne układu pokarmowego i moczowo-płciowego są głównym czynnikiem środowiskowym związanym z rozwojem SpA. Nowe dane wskazują, że bakterie wewnątrzkomórkowe mogą rozprzestrzeniać zakażenie do innych miejsc anatomicznych. U chorych na SpA często występują objawy pozastawowe, zwłaszcza zapalenie jelit. Postęp w zrozumieniu roli mikrobioty jelitowej w homeostazie oraz nowe dane wskazujące na udział zaburzeń mikrobiomu w rozwoju różnych chorób pozwalają lepiej zrozumieć patogenezę SpA. Przypuszcza się, że SpA może się rozwijać na skutek przeniesienia do stawów odpowiedzi immunologicznej, która jest pierwotnie indukowana w jelicie. Przyczyną zapalenia jelit w SpA może być dysbioza, spowodowana przez czynniki genetyczne i środowiskowe.

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Chlamydia-induced reactive arthritis: Hidden in plain sight?

Cited by 29 publications

References 82 publications

Diagnosis of Chlamydia trachomatis in patients with reactive arthritis and undifferentiated spondyloarthropathy

Diagnosis of Chlamydia trachomatis in patients with reactive arthritis and undifferentiated spondyloarthropathy

Chronic Chlamydial Diseases: From Atherosclerosis to Urogenital Infections

New aspects of spondyloarthritis pathogenesis. Part II – environmental factors, microbiome disturbances, extra-articular symptoms

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