The Role of Chlamydia and Chlamydophila Infections in Reactive Arthritis

Rizzo, Antonietta; Domenico, Marina Di; Carratelli, Caterina Romano; Paolillo, Rossella

doi:10.2169/internalmedicine.51.6228

Cited by 22 publications

(20 citation statements)

References 37 publications

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“…Evidently, C trachomatis is present and metabolically active during the remitting phase in synovial tissues from patients with chronic CReA 67. Moreover, simultaneous C pneumoniae and C trachomatis infection was described in a HLA-B27 positive subject with ReA 66. This observation extends an earlier finding of simultaneous detection of DNA from both chlamydial species in synovial tissue of patients with arthritis and undifferentiated SpA 41 42.…”

Section: Clinical Spectrum Of Chlamydial Infectionssupporting

confidence: 75%

“…Moreover, the urogenital infection can sometimes precede the arthritis by several years, or it may be clinically apparent long after appearance of rheumatic signs and symptoms 65. This can result from reinfection or reactivation of persistent infection, either of which can engender arthritis 66. Evidently, C trachomatis is present and metabolically active during the remitting phase in synovial tissues from patients with chronic CReA 67.…”

Section: Clinical Spectrum Of Chlamydial Infectionsmentioning

confidence: 99%

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New insights intoChlamydiaand arthritis. Promise of a cure?

Zeidler

Hudson

2013

Ann Rheum Dis

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Chlamydia trachomatis and Chlamydia pneumoniae together comprise the most frequent causative pathogens that elicit reactive arthritis (ReA). Advances in our understanding of the molecular biology/molecular genetics of these organisms have improved significantly the ability to detect chlamydiae in the joint for diagnostic purposes, as well as extending our current understanding of the pathogenic processes they elicit in the joint and elsewhere. An important aspect of the latter is that synovial chlamydiae infect the joint in an unusual but metabolically active state. While some standard treatments can provide a palliative effect on the ReA disease phenotype, many reports have indicated that standard antibiotic treatment does not provide a cure. Of critical importance, however, two recent reports of controlled clinical trials demonstrated that Chlamydia-ReA can be treated successfully using combination antibiotic therapy. These observations offer the opportunity of a cure for this disease, thereby increasing the practical importance of awareness and diagnosis of the spondyloarthritis caused by Chlamydia. In this viewpoint, we provide an overview of recent key findings in the epidemiology, pathophysiology, clinical manifestations, diagnosis and treatment of Chlamydia-induced arthritis. Our intention is for these insights to be translated rapidly into clinical practice to overcome misdiagnosis and underdiagnosis of the disease, and for them to stimulate the continued development of a cure.

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Section: Clinical Spectrum Of Chlamydial Infectionssupporting

confidence: 75%

Section: Clinical Spectrum Of Chlamydial Infectionsmentioning

confidence: 99%

New insights intoChlamydiaand arthritis. Promise of a cure?

Zeidler

Hudson

2013

Ann Rheum Dis

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“…The particular interaction between chlamydiae and immune cells has been widely investigated to define the role of these intracellular bacteria in human diseases such as atherosclerosis and coronary artery disease, asthma, Alzheimer’s disease, multiple sclerosis and reactive arthritis [30-32]. …”

Section: Discussionmentioning

confidence: 99%

Infection of human monocytes by Chlamydia pneumoniae and Chlamydia trachomatis: an in vitro comparative study

et al. 2014

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BackgroundAn increasing number of studies suggest that chlamydiae can infect immune cells. The altered immune cell function could contribute to the progression of several chronic inflammatory diseases.The aim of this study was to comparatively evaluate Chlamydia pneumoniae (CP) and Chlamydia trachomatis (CT) interactions with in vitro infected human blood monocytes.ResultsFresh isolated monocytes were infected with viable CP and CT elementary bodies and infectivity was evaluated by recultivating disrupted monocytes in permissive epithelial cells.The production of reactive oxygen and nitrogen species was studied in the presence of specific fluorescent probes. Moreover, TNF-α, INF-α, INF-β and INF-γ gene expression was determined.CT clearance from monocytes was complete at any time points after infection, while CP was able to survive up to 48 hours after infection. When NADPH oxydase or nitric oxide synthase inhibitors were used, CT infectivity in monocytes was restored, even if at low level, and CT recovery’s rate was comparable to CP one.CT-infected monocytes produced significantly higher levels of reactive species compared with CP-infected monocytes, at very early time points after infection. In the same meanwhile, TNF-α and INF-γ gene expression was significantly increased in CT-infected monocytes.ConclusionsOur data confirm that CP, but not CT, is able to survive in infected monocytes up to 48 hours post-infection. The delay in reactive species and cytokines production by CP-infected monocytes seems to be crucial for CP survival.

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“…After acute infection the C. trachomatis intracellular life cycle is characterized by the development of metabolically inert atypical inclusions as a permanent source of the bacterial antigen, and inflammatory damage to infected tissues is a primary source of pathology and disease from infection by numerous pathogens such as Chlamydia (Stephens, 2003). In women, untreated genital infections can result in devastating consequences such as pelvic inflammatory disease, ectopic pregnancy and even infertility (Ohman et al, 2009;Crane-Godreau and Wira, 2004) and the development of chronic inflammatory diseases (Rizzo et al, 2012). The initial innate immune response to Chlamydia infections results in the production of a plethora of cytokines and chemokines necessary for the recruitment of T cells and other inflammatory cells needed to initiate adaptive immunity (Derbigny et al, 2012).…”

Section: Introductionmentioning

confidence: 99%