Köhler W, Stelzner A, Kittlick M
Zentralinstitut für Mikrobiologie und Experimentelle Therapie, Akademie der Wissenschaften der DDR, Jena.
Z Gesamte Inn Med. 1987 Aug 1;42(15):428-31.
Regarding of microbiological aspects of arthritis three forms of joint diseases are under investigation: the septic arthritis, the reactive arthritis and the Rheumatoid Arthritis. In 95% of patients with septic arthritis microorganisms as causative agents responsible for the disease are described: Staphylococci, Streptococci, some gram-negative bacteria. By an haematogenic route of infection predominantly patients with immunosuppressive therapy are altered. In newborns and children septic arthritis is to observe more rarely. A reactive arthritis is a postinfectious sterile process in dependence on an infection occurred at an earlier time. As etiologic agents Yersinia, Enterobacteriaceae and Campylobacter have been discovered. 80% of the patients suffering such a reactive arthritis are carrier of the HLA-B27 system. The etiology of the Rheumatoid Arthritis is an open, unanswered problem. Of importance are: immunogenetic conditions, autoimmune phenomena, endocrinologic, dietetic and psychologic factors as well as bacteria and viruses as causative agents: cocci, bacilli, Diphteroids, endoparasitic bacteria (Listeria, L-forms, Mycoplasma, Chlamydiae), viruses (Adeno-, Mumps-, Measles-, ECHO-, Coxsackie-A- and B-, Hepatitis-, Cytomegalo-, Para-influenza-, Retro-, Parvo- and Rubella viruses). In the last years the EBV is of interest covering the question of a distinct virus persistence in tissues and the adequate limiting factors. Perhaps a defect of the hu-IFN-gamma-system might be of immunopathological and clinical significance.
关于关节炎的微生物学方面,有三种关节疾病形式正在研究中:化脓性关节炎、反应性关节炎和类风湿性关节炎。在95%的化脓性关节炎患者中,已描述了作为疾病病原体的微生物:葡萄球菌、链球菌、一些革兰氏阴性菌。通过血源性感染途径,主要是接受免疫抑制治疗的患者受到影响。在新生儿和儿童中,化脓性关节炎较少见。反应性关节炎是一种依赖于早期发生的感染的感染后无菌过程。已发现耶尔森菌、肠杆菌科细菌和弯曲杆菌为病原体。80%患有这种反应性关节炎的患者是HLA - B27系统的携带者。类风湿性关节炎的病因是一个尚未解决的开放性问题。重要的因素包括:免疫遗传条件、自身免疫现象、内分泌、饮食和心理因素以及作为病原体的细菌和病毒:球菌、杆菌、类白喉菌、内寄生菌(李斯特菌、L型菌、支原体、衣原体)、病毒(腺病毒、腮腺炎病毒、麻疹病毒、埃可病毒、柯萨奇A和B组病毒、肝炎病毒、巨细胞病毒、副流感病毒、逆转录病毒、细小病毒和风疹病毒)。近年来,EB病毒备受关注,涉及到其在组织中的独特病毒持续性问题以及适当的限制因素。也许人干扰素γ系统的缺陷可能具有免疫病理学和临床意义。