Institute of Clinical Pathology, Azienda Ospedaliero-Universitaria of Udine, Udine, Italy.
Clin Exp Rheumatol. 2011 Nov-Dec;29(6):977-82. Epub 2011 Dec 22.
Recent evidence indicates that Chlamydophila psittaci (Cp) may establish chronic infections, which may promote autoimmunity and/or B cell lymphoproliferation.
The presence of a subclinical Cp infection was investigated in 293 patients with chronic inflammatory polyarthritis, including 175 patients with rheumatoid factor (RF)-positive and/or anti-CCP-positive rheumatoid arthritis (RA) and 118 with seronegative polyarthritis (46 RF-negative/anti-CCP-negative RA, 36 psoriatic arthritis and 36 undifferentiated spondyloarthritis). One hundred and eighty-five healthy controls were also investigated. The presence of Cp infection was assessed in peripheral blood mononuclear cells using several PCR protocols targeting different regions of the Cp genome (16S-23S spacer rRNA, OMP-A, and Gro-EL). The DNA of other Chlamydia species (C. Pneumoniae and C. Trachomatis) was also investigated. Amplicons were sequenced to confirm the specificity of PCR products.
The presence of a subclinical chronic Cp infection was observed in a significantly higher percentage of patients with chronic polyarthritis (38/293; 13%) compared to healthy controls (1/185, 0.5%; OR=27.4, 95%CI:3.73-201.6, p<0.0001). Furthermore, the prevalence of Cp was higher in seronegative polyarthritis (23/118; 19.5%) than in seropositive RA patients (15/175; 7.4%; OR=2.58, 95%CI: 1.28-5.19, p=0.0078). The highest prevalence of Cp infection was found in RF/anti-CCP double-negative RA patients (13/46, 28.3%), followed by patients with psoriatic arthritis (6/36; 16.7%). No differences in age, sex, disease duration and undergoing therapies were noticed between Cp-positive and Cp-negative patients; nor between seropositive and seronegative patients.
Cp may be an infectious trigger possibly involved in the pathogenesis of a fraction of inflammatory polyarthritis, particularly in seronegative patients.
最近的证据表明鹦鹉热衣原体（Cp）可能会导致慢性感染，这可能会促进自身免疫和/或 B 细胞淋巴增生。
研究了 293 例慢性炎症性多关节炎患者（包括 175 例类风湿因子（RF）阳性和/或抗 CCP 阳性类风湿关节炎（RA）患者和 118 例血清阴性多关节炎患者（46 例 RF/抗 CCP 阴性 RA、36 例银屑病关节炎和 36 例未分化脊柱关节炎））中是否存在亚临床 Cp 感染。还对 185 名健康对照者进行了调查。使用针对 Cp 基因组不同区域（16S-23S 间隔 rRNA、OMP-A 和 Gro-EL）的几种 PCR 方案评估 Cp 感染的存在。还研究了其他衣原体物种（肺炎衣原体和沙眼衣原体）的 DNA。对扩增子进行测序以确认 PCR 产物的特异性。
慢性多关节炎患者（293 例中有 38 例，占 13%）亚临床慢性 Cp 感染的发生率明显高于健康对照组（185 例中有 1 例，占 0.5%；OR=27.4，95%CI：3.73-201.6，p<0.0001）。此外，血清阴性多关节炎患者（118 例中有 23 例，占 19.5%）的 Cp 患病率高于血清阳性 RA 患者（175 例中有 15 例，占 7.4%；OR=2.58，95%CI：1.28-5.19，p=0.0078）。Cp 感染的最高患病率见于 RF/抗 CCP 双阴性 RA 患者（46 例中有 13 例，占 28.3%），其次是银屑病关节炎患者（36 例中有 6 例，占 16.7%）。Cp 阳性和 Cp 阴性患者之间在年龄、性别、疾病持续时间和治疗方面没有差异；血清阳性和血清阴性患者之间也没有差异。
Cp 可能是一种感染性触发因素，可能参与了一部分炎症性多关节炎的发病机制，特别是在血清阴性患者中。
