Horowitz S, Horowitz J, Taylor-Robinson D, Sukenik S, Apte R N, Bar-David J, Thomas B, Gilroy C
Department of Microbiology and Immunology, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University Beer-Sheva, Israel.
J Rheumatol. 1994 May;21(5):877-82.
To evaluate the role of Ureaplasma urealyticum (Uu) in the pathogenesis of Reiter's syndrome (RS).
Infection with Uu was determined in 31 patients with RS and 28 patients with other arthritides by urethral, cervical and synovial fluid (SF) culture and by measuring anti-Uu serum antibody. Infection with Chlamydia trachomatis was determined by examining SF by a direct immunofluorescence technique, by a polymerase chain reaction and by measuring anti-C. trachomatis serum antibody. The proliferative response of SF and peripheral blood mononuclear cells (PBMC) to Uu antigens in patients with RS was compared to that of a control group. The effect that treatment of 6 patients with RS with ciprofloxacin had on repeated cultures, on titer of anti-Uu antibody and on mononuclear cell reactivity was measured sequentially.
The colonization rate of Uu in patients with RS (74%) was significantly greater than in patients with other arthritides (14%). Genital C. trachomatis isolation and serum anti-C. trachomatis antibody were uncommon in both groups (11 and 13%, respectively). SF mononuclear cells of the patients with RS proliferated specifically in response to Uu antigens [up to 6.9 stimulation index (SI)], as did their PBMC (up to 14.5 SI). In some patients, high anti-Uu antibody titers were measured in the serum. Clinical remission was observed in 4 of 6 patients and correlated with eradication of Uu, decrease in antibody titers and disappearance of mononuclear cell reactivity to Uu antigens.
Our findings suggest that Uu might be a causative agent or a trigger in the development of sexually acquired RS.
评估解脲脲原体（Uu）在赖特综合征（RS）发病机制中的作用。
通过尿道、宫颈及滑膜液（SF）培养并检测抗Uu血清抗体，确定31例RS患者和28例其他关节炎患者是否感染Uu。通过直接免疫荧光技术、聚合酶链反应检测SF以及检测抗沙眼衣原体血清抗体，确定是否感染沙眼衣原体。将RS患者的SF和外周血单个核细胞（PBMC）对Uu抗原的增殖反应与对照组进行比较。依次测定6例RS患者使用环丙沙星治疗后对重复培养、抗Uu抗体滴度及单个核细胞反应性的影响。
RS患者中Uu的定植率（74%）显著高于其他关节炎患者（14%）。两组中生殖器沙眼衣原体分离及血清抗沙眼衣原体抗体均不常见（分别为11%和13%）。RS患者的SF单个核细胞对Uu抗原特异性增殖[刺激指数（SI）高达6.9]，其PBMC也是如此（SI高达14.5）。部分患者血清中检测到高抗Uu抗体滴度。6例患者中有4例出现临床缓解，且与Uu根除、抗体滴度降低及单个核细胞对Uu抗原反应性消失相关。
我们的研究结果提示，Uu可能是性传播获得性RS发病的病原体或触发因素。
