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Chlamydia trachomatis and reactive arthritis: the missing link.

A Keat, B Thomas, J Dixey

Lancet (London, England)

|January 10, 1987

Summary

Chlamydia trachomatis, a common cause of sexually transmitted infections, may directly cause reactive inflammatory arthritis. Researchers found evidence of this bacteria in joint fluid of patients with sexually acquired reactive arthritis (SARA).

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Area of Science:

Microbiology
Immunology
Rheumatology

Background:

Reactive inflammatory arthritis often follows non-gonococcal genital-tract infections.
Chlamydia trachomatis is implicated in about 50% of these cases, yet joint cultures are typically sterile.
The direct link between Chlamydia trachomatis and joint inflammation in SARA remains unclear.

Purpose of the Study:

To investigate the presence of Chlamydia trachomatis in joint tissues of patients with sexually acquired reactive arthritis (SARA).
To determine if Chlamydia trachomatis elementary bodies are directly involved in the synovitis of SARA.

Main Methods:

Examined synovial fluid and cells from eight SARA patients and eight controls using a fluorescein-labelled monoclonal antibody for C. trachomatis.
Analyzed joint material for the presence of chlamydial elementary bodies.

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Assessed serum chlamydial antibody titres in patients.

Main Results:

Typical chlamydial elementary bodies were detected in joint material from five out of eight SARA patients.
No chlamydial elementary bodies were found in the control group.
High serum chlamydial antibody titres were observed in the five positive SARA patients.

Conclusions:

The findings suggest a direct role for Chlamydia trachomatis elementary bodies in the synovitis associated with SARA.
This provides evidence for Chlamydia trachomatis as a causative agent in reactive inflammatory arthritis.
Further research may elucidate the mechanisms of Chlamydia-induced joint inflammation.