van der Heijden I M, Res P C, Wilbrink B, Leow A, Breedveld F C, Heesemann J, Tak P P
Department of Rheumatology, Leiden University Hospital, The Netherlands.
Clin Infect Dis. 1997 Oct;25(4):831-7. doi: 10.1086/515535.
To investigate the role of Yersinia persistence in chronic undifferentiated arthritis, two patients who had chronic undifferentiated polyarthritis and circulating IgA and IgG antibodies to Yersinia outer proteins were studied. Immunofluorescence using antibodies directed against Yersinia adhesin A was performed on colonic and synovial tissue. Synovial tissue T cells were cloned aspecifically and screened for their proliferative responses to Yersinia enterocolitica. Furthermore, a Yersinia-specific polymerase chain reaction (PCR) was performed on synovial tissue. Both patients were found to have Yersinia antigens in colonic and synovial tissue. Y. enterocolitica-positive T-cell clones were grown from the synovial tissue: 4 CD4+ clones of 37 clones from patient 1 and 6 CD4+ clones of 53 clones from patient 2. Yersinia-specific PCR products were not detected in the synovial tissue specimens. The results support the hypothesis that an immune-mediated response to Yersinia antigens may play an important role in the pathogenesis of chronic undifferentiated arthritis.
为研究耶尔森菌持续感染在慢性未分化关节炎中的作用，对两名患有慢性未分化多关节炎且循环中存在抗耶尔森菌外膜蛋白IgA和IgG抗体的患者进行了研究。使用抗耶尔森菌黏附素A的抗体对结肠和滑膜组织进行免疫荧光检测。对滑膜组织T细胞进行非特异性克隆，并检测其对小肠结肠炎耶尔森菌的增殖反应。此外，对滑膜组织进行了耶尔森菌特异性聚合酶链反应（PCR）。两名患者的结肠和滑膜组织中均发现有耶尔森菌抗原。从小肠结肠炎耶尔森菌阳性的滑膜组织中培养出T细胞克隆：患者1的37个克隆中有4个CD4+克隆，患者2的53个克隆中有6个CD4+克隆。在滑膜组织标本中未检测到耶尔森菌特异性PCR产物。这些结果支持以下假说：对耶尔森菌抗原的免疫介导反应可能在慢性未分化关节炎的发病机制中起重要作用。
