Detection of Chlamydophila pneumoniae in patients with arthritis: significance and diagnostic value
Detection of Chlamydophila pneumoniae in patients with arthritis: significance and diagnostic value
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DOI：
10.1007/s00296-010-1460-z
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发表时间：
2011-10-01
影响因子：
4
通讯作者：
Seraceni, Silva
中科院分区：
文献类型：
--
作者：
Contini, Carlo;Grilli, Anastasio;Seraceni, Silva
本研究的目的是评估肺炎嗜衣原体在急性和慢性关节炎疾病患者中的潜在临床意义，并调查血液单核细胞是否可能反映伴随的滑膜或持续性全身感染。C.采用针对不同基因的先进PCR和逆转录酶（RT）PCR技术，并结合细胞系培养，对28例关节炎患者的滑液（SF）和外周血单核细胞（PBMC）标本中的肺炎进行了研究。28例患者中有5例（17.8%）发现C。SF或PBMC标本中的肺炎链球菌DNA。诊断为反应性关节炎（ReA）、S.A.P.H.O综合征、银屑病关节炎、未分化少关节炎（UOA）和强直性脊柱炎（AS）。UOA和AS患者的标本也有mRNA转录本，但AS患者的标本则有C。共培养后的肺炎菌生长。此外，还发现C.在抗生素治疗结束时，通过实时PCR（LightCycler）测量的PBMC标本中的肺炎链球菌DNA水平高于SF中发现的水平。C. pneumoniae可能在包括AS在内的慢性关节炎中也起触发因子的作用。培养和分子工具的联合使用提高了检出率，提高了整体灵敏度，表明它们在检测C。肺炎。在监测和评价抗生素治疗的有效性时，应考虑外周和滑膜水平细菌DNA的不同动力学。
The aim of this study was to assess the potential clinical implications of Chlamydophila pneumoniae in patients with acute and chronic arthritic diseases and to investigate whether blood monocytes might reflect a concomitant synovial or persistent systemic infection. C. pneumoniae was investigated with advanced PCR and reverse transcriptase (RT) PCR techniques targeting different genes and combined with cell line cultures, in synovial fluid (SF) and peripheral blood mononuclear cell (PBMC) specimens collected from 28 patients with arthritis. Five out of twenty-eight patients (17.8%) were found to have C. pneumoniae DNA in either SF or PBMC specimens. Their diagnosis was reactive arthritis (ReA), S.A.P.H.O syndrome, psoriatic arthritis, undifferentiated oligoarthritis (UOA) and ankylosing spondylitis (AS). Specimens from patients with UOA and AS had also mRNA transcripts but those from AS yielded C. pneumoniae growth after co-culture. Moreover, C. pneumoniae DNA levels measured by Real-Time PCR (LightCycler) were higher in PBMC specimens compared to those found in SF at the end of antibiotic treatment. C. pneumoniae may have a role as triggering factor also in chronic arthritides including AS. The combined use of culture and molecular tools increases detection rates and improves the overall sensitivity, suggesting their potential use to detect C. pneumoniae. The different kinetics of bacterial DNA at both peripheral and synovial levels should be taken into consideration when monitoring and evaluating the effectiveness of antibiotic treatment.