Abstract
In reactive arthritis (ReA), including Reiter's syndrome, a close relationship between chronic enteric and genitourinary infections and the clinical features of enthesitis has been described. In contrast, in Lyme arthritis, a distinct clinical entity, chronic infection with the tick‐transmitted spirochete Borrelia burgdorferi has been associated with the disease. In a prospective study, 51 patients with ReA were tested for evidence of chlamydial and spirochetal infection. The presence of Chlamydia was determined by culture in 8 patients, and 7 additional patients had markedly elevated antibody titers. In 9 patients, antibodies specific to B burgdorferi were found. Purified peripheral blood T lymphocytes of all 9 patients proliferated specifically to stimulation with macrophages pre‐pulsed with B burgdorferi antigens. Compared with other protein antigens, higher numbers of antigen‐pulsed macrophages were necessary to activate B burgdorferi–specific T cells. Although antibody titers decreased in response to antibiotic treatment in 8 of 9 patients, second‐line therapy with sulfasalazine or methotrexate was required to obtain clinical remission. These data suggest that chronic infection with B burgdorferi can cause ReA. In predisposed individuals, the arthritogenic immune response might be triggered by persisting infectious agents independent of their antigenic specificities.
Original language | English (US) |
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Pages (from-to) | 1057-1064 |
Number of pages | 8 |
Journal | Arthritis & Rheumatism |
Volume | 32 |
Issue number | 9 |
DOIs | |
State | Published - Sep 1989 |
ASJC Scopus subject areas
- Immunology and Allergy
- Rheumatology
- Immunology
- Pharmacology (medical)