Uveitis and arthritis induced by systemic injection of streptococcal cell walls

A single injection of an aqueous suspension of group A streptococcal peptidoglycan-polysaccharide complexes (PG-PS) when injected intraperitoneally into Lewis rats induced a self-limiting bilateral uveitis with associated perpetuating polyarthritis. The uveitis was characterized clinically during the first 72 h by iritis and fibrin deposition. Acutely, there was infiltration of polymorphonuclear cells. The symptoms gradually subsided, and at the close of the experiment eyes were normally clinically and histologically. In contrast, perpetuating inflammation and severe tissue injury developed in the limb. Using an enzyme immunoassay with specificity for the group A streptococcal polysaccharide, the levels of PG-PS in tissues of animals that were killed 1 to 7 days post-injection were measured. The relative amounts of antigen in eye:limb:liver of PG-PS injected animals were 1:9:170. The differences in the amounts of antigen detected in the eye and limb may help explain the development of the acute uveitis in contrast to the perpetuating polyarthritis observed on PG-PS administration. The authors suggest that bacterial debris may act similarly in causing ocular inflammation in man.