Steere Allen C, Glickstein Lisa
Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
Nat Rev Immunol. 2004 Feb;4(2):143-52. doi: 10.1038/nri1267.
Before the first description of Lyme arthritis in 1976, patients with this disease were often thought to have juvenile or adult rheumatoid arthritis. It is now known that Lyme arthritis is caused by a tick-borne spirochete that disseminates to joints, where it induces marked pro-inflammatory responses. In most patients, the arthritis resolves with antibiotic treatment. However, in the United States, about 10% of patients with Lyme arthritis develop persistent synovitis, which lasts for months or even several years after the apparent eradication of the spirochete from the joint with antibiotic therapy. The elucidation of Lyme arthritis, from acute infection to chronic synovitis, might help in our understanding not only of this entity, but also of other forms of chronic inflammatory arthritis, including rheumatoid arthritis.
在1976年首次描述莱姆关节炎之前，患有这种疾病的患者常被认为患有青少年或成人类风湿关节炎。现在已知莱姆关节炎是由一种蜱传播的螺旋体引起的，这种螺旋体扩散到关节，在那里引发明显的促炎反应。在大多数患者中，关节炎通过抗生素治疗得以缓解。然而，在美国，约10%的莱姆关节炎患者会出现持续性滑膜炎，在使用抗生素治疗使螺旋体从关节中明显清除后，这种滑膜炎仍会持续数月甚至数年。对莱姆关节炎从急性感染到慢性滑膜炎的阐释，可能不仅有助于我们了解这种疾病，还能帮助我们理解其他形式的慢性炎症性关节炎，包括类风湿关节炎。
