Follow-up study of reiter's disease and reactive arthritis. Factors influencing the natural course and the prognosis

Leirisalo‐Repo, Marjatta; Skylv, Grethe; Kousa, M

doi:10.1007/bf02203388

Cited by 20 publications

(5 citation statements)

References 15 publications

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“…The role of latent infection and chronic chlamydia! persistence either in the urogenital tract (28) or in the synovium (39) has been discussed. HLA-B27-positive patients have a 50 to 100-fold increased risk of developing reactive arthritis when infected with an appropriate microbe.…”

Section: Discussionmentioning

confidence: 99%

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Are antibiotics of any use in reactive arthritis?

Leirisalo‐Repo

1993

Apmis

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In the pathogenesis of reactive arthritis, infection through the mucosal route and genetic susceptibility (HLA‐B27) are the most important contributing factors. With regard to non‐specific urethritis, most probably caused by Chlamydia trachomatis infection, the use of early antimicrobial therapy has been shown to be effective in preventing arthritic recurrences. When the arthritis has been initiated, short‐term conventional antimicrobial therapy seems unable to modify the course of the ongoing disease. In patients with acute reactive arthritis, a prolonged (3‐month) treatment with tetracycline shortens the duration of arthritis when triggered by Chlamydia trachomatis, while such treatment has not proved effective in enteroarthritis. In patients with chronic reactive enteroarthritis, a prolonged course of quinolones, such as ciprofloxacin, might be of benefit. Sulfasalazine, which has an effect in the acute exacerbations of ankylosing spondylitis, is probably also effective in chronic reactive arthritis. An antimicrobial effect can be one of the mechanisms by which sulfasalazine exerts its therapeutic effect. Follow‐up studies are necessary to assess the influence of antibiotic therapy on the late prognosis of patients with reactive arthritis.

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Section: Discussionmentioning

confidence: 99%

“…tive pathogens via an inflamed and leaking gut mucosa probably also contributes to the increased occurrence of peripheral and axial arthritis (28). The second is the genetic background evidenced by the frequent presence of HLA-B27 in the patients.…”

Section: Urogenital Infectionsmentioning

confidence: 99%

Are antibiotics of any use in reactive arthritis?

Leirisalo‐Repo

1993

Apmis

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“…The association with B27 is most evident in cases which are considered to require referral to rheumatology clinics because of severity or duration. When mild cases in the community are identified, the incidence of B27 falls from the 60-70 % seen for hospital cases to 20-30 % [45], or even occasionally to zero in particular patient cohorts [46]. Thus B27 also predisposes to chronicity rather than the occurrence of arthritis per se ; this predisposition is evident in the most chronic form of spondyloarthropathy, ankylosing spondylitis (to which a minority of patients with reactive arthritis progress), in which more than 90 % of patients are B27 positive.…”

Section: Human Counterpart ?mentioning

confidence: 96%

Role of T-cells in the development of arthritis

Gaston

1998

Clinical Science

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1. Arthritis can be induced in rodents by priming T-cells to respond to a foreign antigen and then challenging with antigen intra-articularly. This may be a model of the situation in human reactive arthritis in which T-cell responses are induced by antigens from organisms which trigger reactive arthritis (e.g. Chlamydia trachomatis) and antigen finds its way to the joint, most probably within macrophages. Priming by previous exposure to antigens similar to those of the triggering organism could also play a part in pathogenesis. Genetic factors determining the nature and control of the immune response affect the severity and duration of the arthritis. 2. T-cell-dependent arthritis can be induced in rodents by immunization with an antigen known to be expressed in the joint (e.g. Type II collagen). Whether this is an important mechanism in human arthritis is still unclear, even though diseases such as rheumatoid arthritis are conventionally thought of as 'autoimmune'. No convincing candidate autoantigen has yet been identified in rheumatoid arthritis, and recent experiments in transgenic mice indicate that arthritis can be induced by an autoimmune T-cell response which does not target an antigen confined to the joint. 3. Adjuvant arthritis is a classical T-cell-dependent animal model of human arthritis; recently arthritis has been described as a rare complication in patients receiving adjuvant (intra-vesical live BCG organisms) for bladder cancer. Increasing attention is being paid to the role of adjuvants as 'danger signals', which allow the immune system to determine whether an antigenic challenge poses a threat. Inappropriate attachment of danger signals to self antigens may result in T-cell-mediated immune responses, which could play a part in the pathogenesis of arthritis. 4. Animal studies indicate that autoimmune/inflammatory diseases can be produced by imbalances within T-cell populations, and that certain T-cells also have the capacity to regulate inflammatory responses. Among the latter are T-cells specific for conserved epitopes within heat shock protein 60. The extent to which T-cells of this kind operate in human disease has yet to be determined.

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“…In addition, HLA-B27-positive patients are predisposed to a more chronic or relapsing course of Reiter's disease. [76][77][78][79][80]…”

Section: Reiter's Syndromementioning

confidence: 99%

Imaging Features of Psoriatic Arthritis and Reiter's Syndrome

Klecker

Weissman²

2003

Semin Musculoskelet Radiol

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Psoriatic arthritis and Reiter's Syndrome are seronegative spondyloarthropathies with characteristic, yet nonspecific, radiographic findings. Radiographic diagnosis is based upon recognition of the classic morphologic changes and knowledge of the articular distribution. Other imaging modalities such as computed tomography (CT), radionuclide imaging, magnetic resonance (MR) imaging, and ultrasonography are also utilized and play specific roles in the evaluation of Psoriatic arthritis and Reiter's Syndrome.

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Follow-up study of reiter's disease and reactive arthritis. Factors influencing the natural course and the prognosis

Cited by 20 publications

References 15 publications

Are antibiotics of any use in reactive arthritis?

Are antibiotics of any use in reactive arthritis?

Role of T-cells in the development of arthritis

Imaging Features of Psoriatic Arthritis and Reiter's Syndrome

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