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

Abstract

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.

Microbe-triggered arthropathies: reactive arthritis and beyond

“…Nevertheless, the results were similar to other studies looking at metabolically active Chlamydia in ReA and USpA . Interestingly, the same group of authors have earlier published the results of a similar study where they have looked at the Chlamydia antigen by PCR in a larger cohort of patients with almost similar prevalence . Contrary to the common belief, the study by Gerard et al .…”

Chlamydia trachomatis -induced reactive arthritis in India: frequency and clinical presentation

“…Intra-articular C. trachomatis major outer membrane protein (MOMP)/plasmid was evident in synovial fluid (SF) of patients with ReA/uSpA (n=45; 24.4%) by seminested (sn)/nested (n) PCR as reported earlier (p<0.05),1 while cytological diagnosis in SF by direct fluorescence assay (DFA) showed the presence of C. trachomatis elementary bodies (31.1%) 2. Anti- C. trachomatis IgA antibodies were also significantly higher in SF and serum (31.1% and 15.5%, respectively) of these patients.…”

“…In India, our group was the first to report intra-articular C. trachomatis infection in patients with ReA/uSpA having genitourinary symptoms 1. Males were predominant (78%) and majority of patients presented with an oligoarthritic profile (80%), enthesitis (11%) and human leukocyte antigen (HLA) B27 (40%); however, none reported ocular infection.…”

Susceptibility of autoimmune diseases in three polymorphisms of infection-associated gene IRAK1

“…The sustained pathology of ADs is directly caused by a specific self-reactive immune response, including innate and adaptive immune response, which can be caused by infection with some kinds of pathogenic microorganisms [5][6][7]. Interleukin-1 (IL-1) receptorassociated kinases (IRAKs) are key mediators in the signaling pathways of innate immune response, especially in the Toll-like receptors (TLRs)/IL-1 receptors (IL-1Rs) pathway.…”