ORIGINAL PAPER
Prevalence, specificity and cross reactivity of anti-bacterial antibodies ( Yersinia spp., Salmonella Enteritidis, Chlamydia trachomatis, Borrelia burgdorferi ) and their role in the diagnosis of undifferentiated arthritis
More details
Hide details
Online publication date: 2011-03-16
Reumatologia 2011;49(1):32-39
KEYWORDS
ABSTRACT
This paper presents the results of research conducted on sera of 4830 patients hospitalized in 2009 in 4 clinical departments of the Institute of Rheumatology in Warsaw. The immunoenzymatic method (ELISA) was used and for confirmation of the presence of antibodies to Yersinia enterocolitica (only in children) and to Borrelia burgdorferi , the Western-blotting method was used. An increased level of antibodies to Yersinia spp. was found in 35.3% of sera and for other microbes, it was: Salmonella Enteritidis – in 13%, Chlamydia trachomatis – in 10.6% and B. burgdorferi – in 14.7% of sera (Table I). The presence of antibodies of particular classes (IgG, IgA and IgM) was analyzed considering their diagnostic usefulness in identification of infection. Special attention was paid to a very high prevalence (in the same serum) of antibodies directed to plural bacteria species (antibodies in the same class were detected in 56.8% and antibodies in different classes were detected in 20.7% of sera) (Table III, IV) . The presence of specific antibodies against Y. enterocolitica was confirmed in 60.8% of sera for IgA class and in 86.7% for IgG class. Analogically, the presence of specific antibodies against B. burgdorferi was confirmed in 82.2% for IgG class and in 45.9% for IgM class (Table II). Additionally, a detailed analysis of the prevalence of antibodies to specific antigens of Y. enterocolitica and B. burgdorferi was done (Fig. 1, 2). Serological diagnosis of undifferentiated arthritis of suspected bacterial origin: Yersinia spp., S. Enteritidis, Ch. trachomatis , B. burgdorferi is generally helpful, due to delayed onset of clinical symptoms. Unfortunately, there are some troubles with interpretation like:
• very frequent detection of antibodies in one class (especially IgG), which is not significant in the diagnosis of infective diseases,
• simultaneous prevalence of antibodies for 2 or 3 bacteria, what reflects the antibodies cross reactivity, additional infection or a previous contact with a pathogen,
• in many cases, confirmation with the use of specific methods is needed, what however considerably increases diagnostic costs.
REFERENCES (16)
1.
Braun J, Kingsley G, Van der Heijde D, et al. On the difficulties of establishing a consensus on the definition of a diagnosis investigations for reactive arthritis. J Rheumatol 2000; 27: 2185-2192. .
2.
Fendler C, Laitko S, Sörensen H, et al. Frequency of triggering bacteria in patients with reactive arthritis and undifferentiated oligoarthritis and the relative importance of the tests used for diagnosis. Ann Rheum Dis 2001; 60: 337-343. .
3.
Sieper J, Rudwaleit M, Braun J, et al. Diagnosing reactive arthritis. Role clinical setting in the value of serologic and microbiologic assays. Arthritis Rheum 2002; 46: 319-327. .
4.
Rihl M, Klos A, Köhler L, et al. Reactive arthritis. Best Pract Res Clin Rheumatol 2006; 20: 1119-1137. .
5.
Gaston JS, Lillicrap MS. Arthritis associated with enteric infection. Best Pract Res Clin Rheumatol 2003; 17: 219-239. .
6.
Mäki-Ikola O, Leirisalo-Repo M, Kantele A, et al. Salmonella-specific antibodies in reactive arthritis. J Infect Dis 1991; 164: 1141-1148. .
7.
Toivanen A, Toivanen P. Reactive arthritis. Best Pract Res Clin Rheumatol 2004; 18: 689-703. .
8.
Hannu T, Inman R, Granfors K, et al. Reactive arthritis or post-infections arthritis? Best Pract Res Clin Rheumatol 2006; 20: 419-433. .
9.
Franz JK, Krause A. Lyme disease (Lyme borreliosis). Best Pract Res Clin Rheumatol 2003; 17: 241-264. .
10.
Sieper J, Braun J. Problems and advances in diagnosis of reactive arthritis. J Rheumatol 1999; 26: 1222-1224. .
11.
Schnarr S, Franz JK, Krause A, et al. Lyme borreliosis. Best Pract Res Clin Rheumatol 2006; 20: 1099-1118. .
12.
Isomäki O, Vuento R, Granfors K. Serological diagnosis of salmonella infections by enzyme immunoassay. Lancet 1989; 1: 1411-1414. .
13.
Rudwaleit M, Richter S, Braun J, et al. Low incidence of reacvtive arthritis following a Salmonella outbreak. Ann Rheum Dis 2001; 60: 1055-1057. .
14.
Kuipers JG, Zeidler H, Köhler L. How does Chlamydia cause arthritis? Rheum Dis Clin N Am 2003; 29: 613-629. .
15.
Witecka-Knysz E, Klimczak M, Lakwa K i wsp. Borelioza: dlaczego diagnostyka jest taka trudna? Diag Lab 2007; 13: 11-13. .
16.
Chmielewski T, Tylewska-Wierzbanowska S. Borelioza z Lyme, laboratoryjne metody rozpoznawania zakażenia. Diagn Lab 2007; 14: 5-7.
Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (
https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.