Granfors K, Jalkanen S, von Essen R, Lahesmaa-Rantala R, Isomäki O, Pekkola-Heino K, Merilahti-Palo R, Saario R, Isomäki H, Toivanen A
Department of Medical Microbiology, University of Turku, Finland.
N Engl J Med. 1989 Jan 26;320(4):216-21. doi: 10.1056/NEJM198901263200404.
We examined synovial-fluid cells from 15 patients with reactive arthritis after yersinia infection for the presence of yersinia antigens. Extensive bacterial cultures of the synovial fluid were negative. All the samples were studied by immunofluorescence with use of a rabbit antiserum to Yersinia enterocolitica O:3 and a monoclonal antibody to Y. enterocolitica O:3 lipopolysaccharide. Synovial-fluid cells from 41 patients with other rheumatic diseases served as controls. Synovial-fluid cells from 10 patients with reactive arthritis after yersinia infection stained positively on immunofluorescence; rabbit antiserum and the monoclonal antibody yielded similar results. In most patients the percentage of positive cells ranged from 1 to 10 percent, but in one patient nearly all the cells in the sample stained strongly. Most of the positively stained cells were polymorphonuclear leukocytes, but yersinia antigens were also found in mononuclear phagocytes. All the control samples were negative. Synovial-fluid cell deposits from nine patients were also studied by Western blotting with use of the same antibodies. The results were positive in six of the nine cell deposits from patients with reactive arthritis and in none of the 10 cell deposits from control patients with rheumatoid arthritis. We conclude that in patients with reactive arthritis after yersinia infection, microbial antigens can be found in synovial-fluid cells from the affected joints.
我们检测了15例耶尔森菌感染后反应性关节炎患者的滑液细胞，以确定是否存在耶尔森菌抗原。滑液的广泛细菌培养结果均为阴性。所有样本均采用兔抗小肠结肠炎耶尔森菌O:3抗血清和抗小肠结肠炎耶尔森菌O:3脂多糖单克隆抗体进行免疫荧光研究。41例其他风湿性疾病患者的滑液细胞作为对照。10例耶尔森菌感染后反应性关节炎患者的滑液细胞免疫荧光染色呈阳性；兔抗血清和单克隆抗体产生了相似的结果。在大多数患者中，阳性细胞百分比为1%至10%，但有1例患者样本中的几乎所有细胞均呈强阳性染色。大多数阳性染色细胞为多形核白细胞，但在单核吞噬细胞中也发现了耶尔森菌抗原。所有对照样本均为阴性。我们还使用相同抗体通过蛋白质印迹法研究了9例患者的滑液细胞沉淀物。在9例反应性关节炎患者的细胞沉淀物中，有6例结果呈阳性，而10例类风湿关节炎对照患者的细胞沉淀物中无一例呈阳性。我们得出结论，在耶尔森菌感染后反应性关节炎患者中，受累关节的滑液细胞中可发现微生物抗原。
