Fendler C, Wu P, Eggens U, Laitko S, Sörensen H, Distler A, Braun J, Sieper J
Deutsches Rheumaforschungszentrum, Department of Nephrology and Rheumatology, Klinikum Benjamin Franklin, Berlin, Germany.
Br J Rheumatol. 1998 Jul;37(7):784-8. doi: 10.1093/rheumatology/37.7.784.
Antigen-specific lymphocyte proliferation of synovial fluid mononuclear cells (SF MNC) has been reported repeatedly in reactive arthritis and Lyme arthritis; however, less information is available on serial investigations of SF MNC in the same patients.
In this study, the synovial lymphocyte proliferation to Yersinia, Chlamydia, Shigella and Borrelia burgdorferi was investigated sequentially at different time points in 28 patients with reactive arthritis, undifferentiated oligoarthritis or Lyme arthritis responding to one of these bacteria.
The same bacterium was always recognized in arthritis triggered by Chlamydia, Shigella or Borrelia, with much variation in the proliferative response. Only the Yersinia-specific responses changed specificity, suggesting that the proliferative response to Yersinia is non-specific in some patients.
Our data support the concept of a local antigen-specific T-cell response in reactive arthritis or Lyme arthritis but not the concept suggested by others that a switch to an autoimmune response takes place in long-standing disease.
反应性关节炎和莱姆关节炎中已多次报道滑液单核细胞（SF MNC）的抗原特异性淋巴细胞增殖；然而，关于同一患者SF MNC的系列研究信息较少。
在本研究中，对28例对这些细菌之一有反应的反应性关节炎、未分化寡关节炎或莱姆关节炎患者，在不同时间点依次研究滑膜淋巴细胞对耶尔森菌、衣原体、志贺菌和伯氏疏螺旋体的增殖情况。
衣原体、志贺菌或伯氏疏螺旋体引发的关节炎中总能识别出相同的细菌，但其增殖反应差异很大。只有耶尔森菌特异性反应改变了特异性，提示在某些患者中对耶尔森菌的增殖反应是非特异性的。
我们的数据支持反应性关节炎或莱姆关节炎中存在局部抗原特异性T细胞反应的概念，但不支持其他人提出的在长期疾病中会转变为自身免疫反应的概念。
