Sprenkels S H, Uksila J, Vainionpää R, Toivanen P, Feltkamp T E
Netherlands Ophthalmic Research Institute, Amsterdam.
Clin Rheumatol. 1996 Jan;15 Suppl 1:52-6. doi: 10.1007/BF03342647.
Acute anterior uveitis (AAU) and ankylosing spondylitis (AS) are, like reactive arthritis (ReA), strongly associated with HLA-B27. Mucosal infections play a role in the pathogenesis of ReA. To investigate whether these microorganisms are also involved in the pathogenesis of AAU and AS, we examined blood samples from patients with AAU, AS or both, and healthy controls for presence of antibodies against Klebsiella pneumoniae (K 30), Salmonella enteritidis and S. typhimurium, Chlamydia trachomatis, Proteus mirabilis and Borrelia burgdorferi. The IgA, IgG and IgM classes of these antibodies were measured using an enzyme-linked immunosorbent assay. No significant differences were found in the frequency in which these antibodies occurred in HLA-B27 positive patients with AAU or AS and healthy controls. However, IgA antibodies against K. pneumoniae (p < 0.01) and IgA and IgG antibodies against P. mirabilis (p < 0.01 and p < 0.05) were detected more frequently in HLA-B27 negative patients with AAU than in healthy controls. The results of this study are in contrast with various earlier reports in which antibodies against Klebsiella strains were more frequently found in patients with HLA-B27 associated ankylosing spondylitis than in healthy controls.
急性前葡萄膜炎（AAU）和强直性脊柱炎（AS）与反应性关节炎（ReA）一样，都与HLA - B27密切相关。黏膜感染在ReA的发病机制中起作用。为了研究这些微生物是否也参与AAU和AS的发病机制，我们检测了AAU患者、AS患者或同时患有这两种疾病的患者以及健康对照者的血样，以检测针对肺炎克雷伯菌（K30）、肠炎沙门氏菌和鼠伤寒沙门氏菌、沙眼衣原体、奇异变形杆菌和伯氏疏螺旋体的抗体。使用酶联免疫吸附测定法检测这些抗体的IgA、IgG和IgM类别。在HLA - B27阳性的AAU或AS患者以及健康对照者中，这些抗体出现的频率没有显著差异。然而，与健康对照者相比，HLA - B27阴性的AAU患者中，针对肺炎克雷伯菌的IgA抗体（p < 0.01）以及针对奇异变形杆菌的IgA和IgG抗体（p < 0.01和p < 0.05）的检测频率更高。本研究结果与早期的各种报告相反，在那些报告中，HLA - B27相关强直性脊柱炎患者中针对克雷伯菌菌株的抗体比健康对照者中更常见。
