Diagnostic significance of the confirmation of the prevalence of antibodies to Yersinia spp., Chlamydia trachomatis and Chlamydophila pneumoniae in the sera of patients with suspected
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Online publication date: 2012-06-27
Reumatologia 2012;50(3):202-210
Background: This paper presents the results of continued research on specific antibacterial antibodies, which are useful in the diagnosis of musculoskeletal diseases of suspected Gram-negative bacterial origin: Yersinia enterocolitica/pseudotuberculosis, Chlamydia trachomatis and Chlamydophila pneumoniae.
Material and methods: The study included 159 positive sera in ELISA screening test of anti-Yersinia spp. antibodies (IgA and/or IgG class) and 38 positive sera of anti-Chlamydia trachomatis antibodies (IgA and/or IgG class). They were confirmed by Western blot, with specific recombinant antigens for these microorganisms. The presence of specific antibodies against Yersinia spp. and Chlamydia trachomatis and/or Chlamydophia pneumoniae (Fig. 1, 2) was confirmed in about 60% of positive sera in ELISA for IgA class and in 75% for IgG class.
Results: Detailed analysis showed that the most common antibodies to recombinant antigens were YOP D for Yersinia spp., for both IgA (98.9%) and IgG (95.3%) class (Fig. 3) and MOMP for Chlamydia trachomatis (Fig. 6) and Chlamydophia pneumoniae (Fig. 7) in the IgA and IgG class (about 85–100%). Unexpected results for anti-Chlamydia spp. antibodies confirmed by Western blot were obtained. It was disclosed that in about 56% of sera were confirmed anti-Chlamydia trachomatis and anti-Chlamydophila pneumoniae antibodies at the same time. This may indicate previous infection or contact with these two species of microorganisms and the antibodies’ cross-reactivity (Fig. 4a, 4b).
Discussion: The obtained results indicate how important is the confirmation by Western blot of Yersinia and Chlamydia spp. infection, due to the high specificity of the Western blot test. It should also be remembered that the serological diagnosis of reactive and undifferentiated arthritis of suspected bacterial origin has to be always in close correlation with the clinical picture and carefully conducted medical history.
Conclusions: The reliability of the serological findings requires additional confirmation of the prevalence of specific antibodies to particular microorganisms in serum and/or circulating immune complexes (CIC). It points to the need for further research in this field that has been already initiated.
Carter JD, Hudson AP. Reactive arthritis: clinical aspects and medical management. Rheum Dis Clin North Am 2009; 35: 21-44.
Carter JD. Bacterial agents in spondyloarthritis: a destiny from diversity? Best Pract Res Clin Rheumatol 2010; 24: 701-714.
Hannu T, Puolakkainen M, Leirisalo-Repo M. Chlamydia pneumoniae as a triggering infection in reactive arthritis. Rheumatology 1999; 38: 411-414.
Kuipers JG, Zeidler H, Köhler L. How does Chlamydia cause arthritis? Rheum Dis Clin North Am 2003; 29: 613-629.
Rihl M, Klos A, Köhler L, et al. Reactive arthritis. Best Pract Res Clin Rheumatol 2006; 20: 1119-1137.
Noworyta J, Brasse-Rumin M, Ząbek J. Ocena wartości serodiagnostyki bakteriologicznej u chorych na niesklasyfikowane zapalenie stawów. Reumatologia 2008; 46: 115-124.
Noworyta J, Brasse-Rumin M, Ząbek J. Ocena wartości serodiagnostyki bakteriologicznej u chorych na niesklasyfikowane zapalenie stawów. Część II. Analiza badań surowic na obecność przeciwciał dla Salmonella enteritidis i Salmonella typhimurium; reakcje krzyżowe z Yersinia enterocolitica O3, Chlamydia trachomatis i Borrelia burgdorferi. Reumatologia 2008; 46: 198-209.
Noworyta J, Brasse-Rumin M, Ząbek J. Ocena wartości serodia-gnostyki bakteriologicznej u chorych na niesklasyfikowane zapalenie stawów. Część III. Metoda immunoenzymatyczna (ELISA) jako test skriningowy w diagnostyce serologicznej zapaleń stawów o podejrzanej etiologii Borrelia burgdorferi; krzyżowa reaktywność przeciwciał dla Borrelia burgdorferi; z Salmonella enteritidis, Salmonella typhimurium Yersinia enterocolitica O3, Chlamydia trachomatis. Reumatologia 2009; 47: 249-257.
Noworyta J, Brasse-Rumin M, Budziszewska M, Ząbek J. Wy-stępowanie, swoistość i krzyżowa reaktywność przeciwciał antybakteryjnych (Yersinia spp., Salmonella enteritidis, Chlamydia trachomatis i Borrelia burgdorferi) oraz ich znaczenie w diagnostyce niesklasyfikowanych zapaleń stawów. Reumatologia 2011; 49: 32-39.
Hoogkamp-Korstanje JA, Moesker H, Bruyn GA. Ciprofloxacin vs. placebo for treatment of Yersinia enterocolitica triggered reactive arthritis. Ann Rheum Dis 2000; 59: 914-917.
Kvien TK, Gaston JS, Bardin T, et al. Three months treatment of reactive arthritis with azithromycin: a EULAR double blind, placebo controlled study. Ann Rheum Dis 2004; 63: 1113-1119.
Sieper J, Fendler C, Laitko S, et al. No benefit of long term ciprofloxacin treatment in subjects with reactive arthritis and undifferentiated oligoarthritis. A three-month, multi- center, double-blind, randomized, placebo- controlled study. Arthritis Rheum 1999; 42: 1386-1396.
Kwiatkowska B, Maślińska M. Postępy w diagnostyce i leczeniu reaktywnego zapalenia stawów. Reumatologia 2011; 49: 354-360.
Stahlberg TH, Heesemann J, Granfors K, et al. Immunoblot analysis of IgM, IgG and IgA response to plazmid encoded released protein of Yersinia enterocolitica in patients with or without yersinia triggered reactive arthritis. Ann Rheum Dis 1989; 48: 577-581.
Cremer J, Putzker M, Faulde M, et al. Immunoblotting of Yersinia plasmid-encoded released proteins: A tool for diagnosis. Electroforesis 1993; 14: 952-959.
Heesemann J, Eggers C, Schröder J Serological diagnosis of yersiniosis by immunoblot technique using virulence- associated antigen of enteropathogenic Yersiniae. Contr Microbiol Immunobiol 1987; 9: 285-289.
Bas S, Muzzin P, Ninet B, et al. Chlamydial serology: Comparative diagnostic value of immunoblotting, microimmunofluorescence test, and immunoassays using different recombinant proteins as antigens: J Clin Microbiol 2001; 39: 1368-1377.
Brunham RC, Peeling RW. Chlamydia trachomatis antigens: role in immunity and pathogenesis. Inf Agents Dis 1994; 3: 218-233.
Iijima Y, Miyashita N, Kishimoto T, et al. Characterization of Chlamydia pneumoniae species – specific proteins immunodominant in humans. J Clin Microbiol 1994; 32: 583-588.
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