Sieper J, Braun J, Brandt J, Miksits K, Heesemann J, Laitko S, Sörensen H, Distler A, Kingsley G
Department of Medicine, Free University of Berlin, Germany.
J Rheumatol. 1992 Aug;19(8):1236-42.
We studied the cellular and humoral immune response to Chlamydia trachomatis, Yersinia enterocolitica and Borrelia burgdorferi in paired samples of peripheral blood and synovial fluid (SF) in undifferentiated oligoarthritis, reactive arthritis (ReA) and rheumatoid arthritis. Antigen specific lymphocyte proliferation was found in SF of 43% of patients with ReA and 34% of patients with undifferentiated oligoarthritis. C. trachomatis was the most frequent single agent. HLA-B27 was positive in 83% of patients with ReA and in 62% of patients with undifferentiated oligoarthritis with antigen specific lymphocyte proliferation. Antigen specific lymphocyte proliferation correlated poorly with the specific antibody response. Only chlamydial antigen was detected in SF cells using monoclonal antibodies. We conclude that some patients with undifferentiated oligoarthritis may have a forme fruste of ReA. This finding is important in view of recent evidence supporting the efficacy of antibiotic therapy in ReA.
我们研究了未分化寡关节炎、反应性关节炎（ReA）和类风湿关节炎患者外周血与滑液（SF）配对样本中对沙眼衣原体、小肠结肠炎耶尔森菌和伯氏疏螺旋体的细胞免疫和体液免疫反应。在43%的ReA患者和34%的未分化寡关节炎患者的SF中发现了抗原特异性淋巴细胞增殖。沙眼衣原体是最常见的单一病原体。83%的ReA患者和62%有抗原特异性淋巴细胞增殖的未分化寡关节炎患者HLA - B27呈阳性。抗原特异性淋巴细胞增殖与特异性抗体反应相关性较差。使用单克隆抗体仅在SF细胞中检测到衣原体抗原。我们得出结论，一些未分化寡关节炎患者可能患有ReA的顿挫型。鉴于最近支持抗生素治疗ReA有效性的证据，这一发现具有重要意义。
