|
1
|
He T, Qian W. Immunologic derangement caused by intestinal dysbiosis and stress is the intrinsic basis of reactive arthritis. Z Rheumatol 2024; 83:305-313. [PMID: 38403666 PMCID: PMC11655581 DOI: 10.1007/s00393-024-01480-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2024] [Indexed: 02/27/2024]
Abstract
Reactive arthritis (ReA) is defined as arthritis resulting from infections in other body parts, such as the gastrointestinal and urogenital tracts. The primary clinical manifestations involve acute-onset and self-limiting asymmetric large joint inflammation in the lower limbs. Although bacterial or chlamydia infections have long been recognized as playing a pivotal role in its pathogenesis, recent studies suggest that antibiotic treatment may perpetuate rather than eradicate chlamydia within the host, indicating an involvement of other mechanisms in Reactive arthritis. Reactive arthritis is currently believed to be associated with infection, genetic marker (HLA-B27), and immunologic derangement. As an autoimmune disease, increasing attention has been given to understanding the role of the immune system in Reactive arthritis. This review focuses on elucidating how the immune system mediates reactive arthritis and explores the roles of intestinal dysbiosis-induced immune disorders and stress-related factors in autoimmune diseases, providing novel insights into understanding reactive arthritis.
Collapse
Affiliation(s)
- Tao He
- Nanjing University of Chinese Medicine, Nanjing, China
| | - Weiqing Qian
- Nanjing City Hospital of Chinese Medicine, 157, Daming Road, Nanjing, Qinhuai District, China.
| |
Collapse
|
|
2
|
Chohan A, Qureshi M, Huda M, Karunakaran Thozhuthumparambil P. An Unusual Case of Haemophilus influenzae Associated Polyarthritis: Diagnostic and Therapeutic Challenges in Concurrent Septic and Reactive Arthritis. Cureus 2024; 16:e73194. [PMID: 39524174 PMCID: PMC11543375 DOI: 10.7759/cureus.73194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2024] [Indexed: 11/16/2024] Open
Abstract
Septic arthritis and reactive arthritis are both recognized as distinct causes of swollen joints; however, they can, at times, overlap as causes of acute polyarthritis. Septic arthritis is an orthopedic emergency, typically caused by bacterial infection, and requires urgent antibiotic treatment and joint drainage to prevent irreversible joint damage. In contrast, reactive arthritis is a sterile, immune-mediated arthritis that occurs following infections and is managed with anti-inflammatory treatments such as corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs). We report the case of a 47-year-old, previously healthy male presenting with acute severe polyarthritis, including both large and small joints, fever, and flu-like symptoms. Blood cultures were positive for Haemophilus influenzae, leading to targeted antibiotic treatment for septicemia. However, given the rapid progression of asymmetrical polyarthralgia and systemic features, reactive arthritis was also suspected, and corticosteroids were commenced. Despite this, persistent fever and worsening joint symptoms raised concerns for septic arthritis in the left knee. Arthroscopy of the left knee revealed synovitis; however, the joint fluid culture was sterile on culture. Ultimately, polymerase chain reaction (PCR) of the fluid confirmed Haemophilus influenzae septic arthritis. Steroids were discontinued, and arthroscopic washout alongside targeted antibiotic therapy led to improved symptoms and inflammatory markers. However, despite gradual clinical improvement, the patient continued to have persistent polyarthralgia, raising the possibility of concurrent reactive polyarthritis alongside septic arthritis. On follow-up, rheumatology is managing chronic reactive arthritis. This case underscores the diagnostic challenges in distinguishing septic arthritis from reactive arthritis in atypical presentations, such as H. influenzae infection. Concurrent arthropathies must also be considered, and no guidelines have been found to address this possibility. This raises the challenge of implementing conflicting therapies, such as corticosteroids for reactive arthritis, that could potentially worsen septic arthritis outcomes. Recognizing the potential consequence of sepsis and septic arthritis, early antibiotic therapy was initiated. Furthermore, a persistent suspicion of septic arthritis, even in the presence of features suggestive of reactive arthritis, led to diagnosis and effective treatment. Further evidence-based guidelines are needed to aid clinicians in managing two or more co-presenting arthropathies.
Collapse
Affiliation(s)
- Ashrit Chohan
- Acute Medicine, Sandwell and West Birmingham NHS Trust, Birmingham, GBR
| | - Maahi Qureshi
- Acute Medicine, Sandwell and West Birmingham NHS Trust, Birmingham, GBR
| | - Mainul Huda
- Acute Medicine, Sandwell and West Birmingham NHS Trust, Birmingham, GBR
| | | |
Collapse
|
|
3
|
Elkins M, Jain N, Tükel Ç. The menace within: bacterial amyloids as a trigger for autoimmune and neurodegenerative diseases. Curr Opin Microbiol 2024; 79:102473. [PMID: 38608623 PMCID: PMC11162901 DOI: 10.1016/j.mib.2024.102473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/20/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024]
Abstract
Bacteria are known to produce amyloids, proteins characterized by a conserved cross-beta sheet structure, which exhibit structural and functional similarities to human amyloids. The deposition of human amyloids into fibrillar plaques within organs is closely linked to several debilitating human diseases, including Alzheimer's and Parkinson's disease. Recently, bacterial amyloids have garnered significant attention as potential initiators of human amyloid-associated diseases as well as autoimmune diseases. This review aims to explore how bacterial amyloid, particularly curli found in gut biofilms, can act as a trigger for neurodegenerative and autoimmune diseases. We will elucidate three primary mechanisms through which bacterial amyloids exert their influence: By delving into these three distinct modes of action, this review will provide valuable insights into the intricate relationship between bacterial amyloids and the onset or progression of neurodegenerative and autoimmune diseases. A comprehensive understanding of these mechanisms may open new avenues for therapeutic interventions and preventive strategies targeting amyloid-associated diseases.
Collapse
Affiliation(s)
- Molly Elkins
- Center for Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA
| | - Neha Jain
- Department of Bioscience and Bioengineering, Indian Institute of Technology Jodhpur, NH 62, Surpura Bypass, Karwar, Rajasthan, India
| | - Çagla Tükel
- Center for Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA.
| |
Collapse
|
|
4
|
Liu C, Yan Z, Zhang X, Xia T, Ashaolu JO, Olatunji OJ, Ashaolu TJ. Food-derived bioactive peptides potentiating therapeutic intervention in rheumatoid arthritis. Heliyon 2024; 10:e31104. [PMID: 38778960 PMCID: PMC11109807 DOI: 10.1016/j.heliyon.2024.e31104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/09/2024] [Accepted: 05/09/2024] [Indexed: 05/25/2024] Open
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that affects the joints of the human body and is projected to have a prevalence age-standardized rate of 1.5 million new cases worldwide by 2030. Several conventional and non-conventional preventive and therapeutic interventions have been suggested but they have their side effects including nausea, abdominal pain, liver damage, ulcers, heightened blood pressure, coagulation, and bleeding. Interestingly, several food-derived peptides (FDPs) from both plant and animal sources are increasingly gaining a reputation for their potential in the management or therapy of RA with little or no side effects. In this review, the concept of inflammation, its major types (acute and chronic), and RA identified as a chronic type were discussed based on its pathogenesis and pathophysiology. The conventional treatment options for RA were briefly outlined as the backdrop of introducing the FDPs that potentiate therapeutic effects in the management of RA.
Collapse
Affiliation(s)
- Chunhong Liu
- Second People's Hospital of Wuhu City, 241001, Anhui, China
| | - Zheng Yan
- Second People's Hospital of Wuhu City, 241001, Anhui, China
| | - Xiaohai Zhang
- Second People's Hospital of Wuhu City, 241001, Anhui, China
| | - Taibao Xia
- Second People's Hospital of Wuhu City, 241001, Anhui, China
| | - Joseph Opeoluwa Ashaolu
- Department of Public Health, Faculty of Basic Medical Sciences, Redeemers University, PMB 230, Ede, Osun State, Nigeria
| | | | - Tolulope Joshua Ashaolu
- Institute for Global Health Innovations, Duy Tan University, Da Nang, 550000, Viet Nam
- Faculty of Medicine, Duy Tan University, Da Nang, 550000, Viet Nam
| |
Collapse
|
|
5
|
Jin XY, Li DD, Quan W, Chao Y, Zhang B. Leaky gut, circulating immune complexes, arthralgia, and arthritis in IBD: coincidence or inevitability? Front Immunol 2024; 15:1347901. [PMID: 38571963 PMCID: PMC10987687 DOI: 10.3389/fimmu.2024.1347901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/07/2024] [Indexed: 04/05/2024] Open
Abstract
Most host-microbiota interactions occur within the intestinal barrier, which is essential for separating the intestinal epithelium from toxins, microorganisms, and antigens in the gut lumen. Gut inflammation allows pathogenic bacteria to enter the blood stream, forming immune complexes which may deposit on organs. Despite increased circulating immune complexes (CICs) in patients with inflammatory bowel disease (IBD) and discussions among IBD experts regarding their potential pathogenic role in extra-intestinal manifestations, this phenomenon is overlooked because definitive evidence demonstrating CIC-induced extra-intestinal manifestations in IBD animal models is lacking. However, clinical observations of elevated CICs in newly diagnosed, untreated patients with IBD have reignited research into their potential pathogenic implications. Musculoskeletal symptoms are the most prevalent extra-intestinal IBD manifestations. CICs are pivotal in various arthritis forms, including reactive, rheumatoid, and Lyme arthritis and systemic lupus erythematosus. Research indicates that intestinal barrier restoration during the pre-phase of arthritis could inhibit arthritis development. In the absence of animal models supporting extra-intestinal IBD manifestations, this paper aims to comprehensively explore the relationship between CICs and arthritis onset via a multifaceted analysis to offer a fresh perspective for further investigation and provide novel insights into the interplay between CICs and arthritis development in IBD.
Collapse
Affiliation(s)
- Xi-ya Jin
- Department of Gastroenterology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Dan-dan Li
- Department of Gastroenterology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Wei Quan
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Yang Chao
- Department of Gastroenterology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Bin Zhang
- Department of Gastroenterology, China-Japan Union Hospital of Jilin University, Changchun, China
| |
Collapse
|
|
6
|
Pavelić E, Glavaš Weinberger D, Čemerin M, Rod E, Primorac D. Diagnostic considerations in the clinical management of sudden swelling of the knee: a case report and review of the literature. J Med Case Rep 2024; 18:35. [PMID: 38281947 PMCID: PMC10823606 DOI: 10.1186/s13256-023-04336-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/24/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Reactive arthritis and septic arthritis rarely present concomitantly in the same joint and patient. Reactive arthritis presenting after coronavirus disease 2019 is also exceedingly rare, with less than 30 cases reported thus far. Less common pathogens such as Clostridium difficile have been reported to cause reactive arthritis, especially in patients with a positive human leukocyte antigen B27, and therefore should be considered in diagnostic algorithms. The aim of this case report is to highlight the difficulties and precautions in discerning and diagnosing patients presenting with sudden swelling of the knee. CASE PRESENTATION We report the case of a 70-year-old Caucasian male with a recent history of coronavirus disease 2019 upper respiratory infection and diarrhea and negating trauma, who presented with a swollen and painful knee. Pain and swelling worsened and inflammatory parameters increased after an intraarticular corticosteroid injection. The patient was therefore treated with arthroscopic lavage and intravenous antibiotics for suspected septic arthritis. Synovial fluid and synovium samples were taken and sent for microbiological analysis. Synovial fluid cytology showed increased leukocytes at 10,980 × 106/L, while polymerase chain reaction and cultures came back sterile. Clostridium difficile toxin was later detected from a stool sample and the patient was treated with oral vancomycin. The patient was tested for the presence of human leukocyte antigen B27, which was positive. We present a review of the literature about the challenges of distinguishing septic from reactive arthritis, and about the mechanisms that predispose certain patients to this rheumatological disease. CONCLUSIONS It is still a challenge to differentiate between septic and reactive arthritis of the knee, and it is even more challenging to identify the exact cause of reactive arthritis. This case report of a human leukocyte antigen-B27-positive patient highlights the necessity of contemplating different, less common causes of a swollen knee joint as a differential diagnosis of an apparent septic infection, especially in the coronavirus disease 2019 era. Treating the patient for septic arthritis prevented any possible complications of such a condition, while treating the C. difficile infection contributed to the substantial relief of symptoms.
Collapse
Affiliation(s)
- Eduard Pavelić
- St. Catherine Specialty Hospital, Ulica Kneza Branimira 71E, Zagreb, Croatia.
- Department of Orthopedics and Traumatology, St. Catherine Specialty Hospital, Ulica Kneza Branimira 71E, 10000, Zagreb, Croatia.
| | | | - Martin Čemerin
- St. Catherine Specialty Hospital, Ulica Kneza Branimira 71E, Zagreb, Croatia
| | - Eduard Rod
- St. Catherine Specialty Hospital, Ulica Kneza Branimira 71E, Zagreb, Croatia
- Department of Orthopedics and Traumatology, St. Catherine Specialty Hospital, Ulica Kneza Branimira 71E, 10000, Zagreb, Croatia
| | - Dragan Primorac
- St. Catherine Specialty Hospital, Ulica Kneza Branimira 71E, Zagreb, Croatia
- Medical School, University of Split, Šoltanska Ulica 2, Split, Croatia
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Ulica Josipa Huttlera 4, Osijek, Croatia
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena Ulica 21, Osijek, Croatia
- Medical School, University of Rijeka, Ulica braće Branchetta 20/1, Rijeka, Croatia
- Medical School REGIOMED, Gustav-Hirschfeld-Ring 3, Coburg, Germany
- Eberly College of Science, The Pennsylvania State University, 517 Thomas Building, University Park, PA, USA
- The Henry C. Lee College of Criminal Justice and Forensic Sciences, University of New Haven, 300 Boston Post Road, West Haven, CT, USA
| |
Collapse
|
|
7
|
Grando K, Bessho S, Harrell K, Kyrylchuk K, Pantoja AM, Olubajo S, Albicoro FJ, Klein-Szanto A, Tükel Ç. Bacterial amyloid curli activates the host unfolded protein response via IRE1α in the presence of HLA-B27. Gut Microbes 2024; 16:2392877. [PMID: 39189642 PMCID: PMC11352795 DOI: 10.1080/19490976.2024.2392877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 08/05/2024] [Accepted: 08/12/2024] [Indexed: 08/28/2024] Open
Abstract
Salmonella enterica serovar Typhimurium (STm) causes gastroenteritis and can progress to reactive arthritis (ReA). STm forms biofilms in the gut that secrete the amyloid curli, which we previously demonstrated can trigger autoimmunity in mice. HLA-B27 is a genetic risk factor for ReA; activation of the unfolded protein response (UPR) due to HLA-B27 misfolding is thought to play a critical role in ReA pathogenesis. To determine whether curli exacerbates HLA-B27-induced UPR, bone marrow-derived macrophages (BMDMs) isolated from HLA-B27 transgenic (tg) mice were used. BMDMs treated with purified curli exhibited elevated UPR compared to C57BL/6, and curli-induced IL-6 was reduced by pre-treating macrophages with inhibitors of the IRE1α branch of the UPR. In BMDMs, intracellular curli colocalized with GRP78, a regulator of the UPR. In vivo, acute infection with wild-type STm increased UPR markers in the ceca of HLA-B27tg mice compared to C57BL/6. STm biofilms that contain curli were visible in the lumen of cecal tissue sections. Furthermore, curli was associated with macrophages in the lamina propria, colocalizing with GRP78. Together, these results suggest that UPR plays a role in the curli-induced inflammatory response, especially in the presence of HLA-B27, a possible mechanistic link between STm infection and genetic susceptibility to ReA.
Collapse
Affiliation(s)
- Kaitlyn Grando
- Center for Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Shingo Bessho
- Center for Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Kayla Harrell
- Center for Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Kathrine Kyrylchuk
- Center for Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Alejandro M. Pantoja
- Center for Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Sophia Olubajo
- Center for Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Francisco J. Albicoro
- Center for Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | | | - Çagla Tükel
- Center for Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| |
Collapse
|
|
8
|
Nasrallah OG, Mohty R, El-Cheikh J, Merashli M. Systemic Mastocytosis: A Mimicker of Reactive Arthritis. Case Rep Rheumatol 2023; 2023:6655005. [PMID: 37584057 PMCID: PMC10425246 DOI: 10.1155/2023/6655005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/14/2023] [Accepted: 07/15/2023] [Indexed: 08/17/2023] Open
Abstract
Objectives Illustration of a case of systemic mastocytosis mimicking reactive arthritis in the absence of an infectious etiology. Methods Review of the patient's medical records. Results We report a case of systemic mastocytosis relapse, presenting with pancytopenia accompanied by knee monoarthritis, cystitis, and bilateral conjunctivitis occurring simultaneously at the same time interval within 2-4 days, mimicking reactive arthritis in the absence of an infectious etiology. Conclusion Our case demonstrated reactive arthritis features (triad of urethritis, conjunctivitis, and arthritis) without an infectious trigger but rather a relapse of mastocytosis. We should think outside the box when faced with such a clinical scenario in the absence of an infectious etiology. Paraneoplastic reactive arthritis is to be considered after excluding an underlying infection.
Collapse
Affiliation(s)
- Oussama G. Nasrallah
- Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Razan Mohty
- Division of Hematology, Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Jean El-Cheikh
- Division of Hematology, Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mira Merashli
- Division of Rheumatology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| |
Collapse
|
|
9
|
Abdulmomen I, Satti E, Awadh B. Peripheral Spondyloarthritis Presenting with Fever and Severe Systemic Inflammatory Response Mimicking Infection: A Case Series and Literature Review. Case Rep Rheumatol 2023; 2023:6651961. [PMID: 37502695 PMCID: PMC10371696 DOI: 10.1155/2023/6651961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 07/07/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023] Open
Abstract
Objective To describe four peripheral spondyloarthritis patients presenting with fever and severe systemic inflammatory response mimicking infection. Methods Between 2017 and 2019, four patients with the final diagnosis of peripheral spondyloarthritis had atypical presentation of fever and severe systemic inflammatory response requiring hospital admission and extensive workup. Results We reported four patients who were admitted to the hospital for fever and arthritis. They all had laboratory tests of the severe systemic inflammatory response (leukocytosis, thrombocytosis, high ESR, and high CRP) concerning infection. They underwent extensive workup for infectious causes, including septic arthritis, which came back negative. Other rheumatic diseases that are known to present with fever such as adult-onset Still's disease, reactive arthritis, and crystal arthritis were all excluded. The final diagnosis of spondyloarthritis was made during their follow-up: three patients with peripheral spondyloarthritis and one with psoriatic arthritis. All patients received conventional DMARDs (methotrexate and sulfasalazine) and two patients received tumor necrosis factor inhibitors in addition to conventional DMARDs to control their disease. Conclusion We observed a subgroup of peripheral spondyloarthritis patients presenting with fever and severe systemic inflammatory response requiring hospitalization. Recognition of this subgroup is important and should be considered once an infection is ruled out.
Collapse
Affiliation(s)
- Ibrahim Abdulmomen
- Rheumatology Division, Department of Medicine, Hamad General Hospital, Doha, Qatar
| | - Eman Satti
- Rheumatology Division, Department of Medicine, Hamad General Hospital, Doha, Qatar
| | - Basem Awadh
- Rheumatology Division, Department of Medicine, Hamad General Hospital, Doha, Qatar
| |
Collapse
|
|
10
|
Migliorini F, Bell A, Vaishya R, Eschweiler J, Hildebrand F, Maffulli N. Reactive arthritis following COVID-19 current evidence, diagnosis, and management strategies. J Orthop Surg Res 2023; 18:205. [PMID: 36922870 PMCID: PMC10017067 DOI: 10.1186/s13018-023-03651-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/25/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND Immune-mediated conditions associated to Corona Virus Disease-19 (COVID-19) have been reported, including vasculitis, antiphospholipid antibody syndrome, myositis, and lupus. Emerging studies have reported the potential occurrence of reactive arthritis in patients previously infected with COVID-19. This systematic review summarised the current evidence on the occurrence of reactive arthritis in patients previously infected by COVID-19. METHODS This study was conducted according to the 2020 PRISMA guidelines. All the clinical investigations describing the occurrence of reactive arthritis following COVID-19 were accessed. In September 2022, the following databases were accessed: PubMed, Web of Science, Google Scholar, Embase. The generalities of the study were extracted: author, year and journal of publication, country of the main author, study design, sample size, mean age, number of women, main results of the study. The following data on COVID-19 severity and management were retrieved: type of treatment, hospitalization regimes (inpatient or outpatient), admission to the intensive care unit, need of mechanical ventilation, pharmacological management. The following data on reactive arthritis were collected: time elapsed between COVID-19 infection to the onset of reactive arthritis symptoms (days), pharmacological management, type of arthritis (mono- or bilateral, mono- or polyarticular), extra-articular manifestations, presence of tenosynovitis or enthesitis, synovial examination at microscopic polarised light, imaging (radiography, magnetic resonance, sonography), clinical examination, laboratory findings. RESULTS Data from 27 case reports (54 patients) were retrieved, with a mean age of 49.8 ± 14.5 years. 54% (29 of 54 patients) were women. The mean time span between COVID-19 infection and the occurrence of reactive arthritis symptoms was 22.3 ± 10.7 days. Between studies diagnosis and management of reactive arthritis were heterogeneous. Symptoms resolved within few days in all studies considered. At last follow-up, all patients were minimally symptomatic or asymptomatic, and no additional therapy or attentions were required by any patient. CONCLUSION Poor evidence suggests that COVID-19 could target the musculoskeletal system causing reactive arthritis at its post infectious stage. COVID-19 can act as a causative agent or as a trigger for development of reactive arthritis even without presence of antibodies of rheumatological disorders. Treating physicians should have a high index of suspicion while treating post infectious COVID-19 patient with arthralgia. LEVEL OF EVIDENCE Level IV, systematic review.
Collapse
Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany. .,Department of Orthopaedic and Trauma Surgery, Eifelklinik St. Brigida, 52152, Simmerath, Germany.
| | - Andreas Bell
- Department of Orthopaedic and Trauma Surgery, Eifelklinik St. Brigida, 52152, Simmerath, Germany
| | - Raju Vaishya
- Department of Orthopaedics, Indraprastha Apollo Hospitals Institutes of Orthopaedics, New Delhi, India
| | - Jörg Eschweiler
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Frank Hildebrand
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081, Baronissi, SA, Italy.,Faculty of Medicine, School of Pharmacy and Bioengineering, Keele University, Stoke-on-Trent, ST4 7QB, England.,Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, Queen Mary University of London, London, E1 4DG, England
| |
Collapse
|
|
11
|
Yan LF, Zhang J, Zhang Z. Reactive arthritis and subacute infective endocarditis caused by Streptococcus gordonii infection: A case report. Int J Rheum Dis 2023; 26:376-378. [PMID: 36314763 DOI: 10.1111/1756-185x.14481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/08/2022] [Accepted: 10/14/2022] [Indexed: 01/28/2023]
Abstract
Streptococcus gordonii (S. gordonii) belongs to the alpha-hemolytic Streptococcus group. It is a symbiotic bacterium found in the human oral mucosa which is present in large quantities on the surface of the teeth. It is generally considered nonpathogenic or weakly pathogenic and is known to cause subacute endocarditis; however, there are few reports of reactive arthritis (ReA) caused by S. gordonii. Herein, we report a case of ReA complicated by subacute infective endocarditis caused by S. gordonii and explore the possible pathogenic mechanism of ReA caused by S. gordonii.
Collapse
Affiliation(s)
- Li-Fang Yan
- Department of Rheumatism and Immunology, Qinghai Red Cross Hospital, Xining, China
| | - Jie Zhang
- Department of Rheumatism and Immunology, Qinghai Red Cross Hospital, Xining, China
| | - Zhen Zhang
- Department of Rheumatism and Immunology, Qinghai Red Cross Hospital, Xining, China
| |
Collapse
|
|
12
|
Wang CR, Tsai HW. Seronegative spondyloarthropathy-associated inflammatory bowel disease. World J Gastroenterol 2023; 29:450-468. [PMID: 36688014 PMCID: PMC9850936 DOI: 10.3748/wjg.v29.i3.450] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/18/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
Seronegative spondyloarthropathy (SpA) usually starts in the third decade of life with negative rheumatoid factor, human leukocyte antigen-B27 genetic marker and clinical features of spinal and peripheral arthritis, dactylitis, enthesitis and extra-articular manifestations (EAMs). Cases can be classified as ankylosing spondylitis, psoriatic arthritis, reactive arthritis, enteropathic arthritis, or juvenile-onset spondyloarthritis. Joint and gut inflammation is intricately linked in SpA and inflammatory bowel disease (IBD), with shared genetic and immunopathogenic mechanisms. IBD is a common EAM in SpA patients, while extraintestinal manifestations in IBD patients mostly affect the joints. Although individual protocols are available for the management of each disease, the standard therapeutic guidelines of SpA-associated IBD patients remain to be established. Nonsteroidal anti-inflammatory drugs are recommended as initial therapy of peripheral and axial SpA, whereas their use is controversial in IBD due to associated disease flares. Conventional disease-modifying anti-rheumatic drugs are beneficial for peripheral arthritis but ineffective for axial SpA or IBD therapy. Anti-tumor necrosis factor monoclonal antibodies are effective medications with indicated use in SpA and IBD, and a drug of choice for treating SpA-associated IBD. Janus kinase inhibitors, approved for treating SpA and ulcerative colitis, are promising therapeutics in SpA coexistent with ulcerative colitis. A tight collaboration between gastroenterologists and rheumatologists with mutual referral from early accurate diagnosis to appropriately prompt therapy is required in this complex clinical scenario.
Collapse
Affiliation(s)
- Chrong-Reen Wang
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan 70403, Taiwan
| | - Hung-Wen Tsai
- Department of Pathology, National Cheng Kung University Hospital, Tainan 70403, Taiwan
| |
Collapse
|
|
13
|
Higashiguchi M, Matsumoto T, Kitamura T, Nakajima T, Nishioka K, Kimura H, Yamamoto T, Komuta K. Poncet's Disease (Reactive Arthritis Associated with Tuberculosis). Intern Med 2022; 61:3245-3249. [PMID: 35342140 PMCID: PMC9683800 DOI: 10.2169/internalmedicine.9241-21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
An 82-year-old man with miliary tuberculosis was admitted to our hospital. Approximately six weeks after starting anti-tuberculosis treatment, he complained of pain in the fingers, wrists, and ankles. A histopathological examination of the synovial biopsy revealed nonspecific chronic inflammation with no granulomas. Culture of the biopsy specimen yielded no acid-fast bacilli. Poncet's disease was diagnosed based on the clinical presentation, with no findings suggestive of other diseases. His joint pain rapidly improved with steroid therapy. Tuberculosis can cause arthritis through immune-mediated mechanisms without direct invasion in an entity known as Poncet's disease.
Collapse
Affiliation(s)
- Masayoshi Higashiguchi
- Department of Internal Medicine, Osaka Anti-Tuberculosis Association Osaka Fukujuji Hospital, Japan
| | - Tomoshige Matsumoto
- Department of Internal Medicine, Osaka Anti-Tuberculosis Association Osaka Fukujuji Hospital, Japan
| | - Takashi Kitamura
- Department of Orthopedic Surgery, Osaka Anti-Tuberculosis Association Osaka Fukujuji Hospital, Japan
| | - Takako Nakajima
- Department of Orthopedic Surgery, Osaka Anti-Tuberculosis Association Osaka Fukujuji Hospital, Japan
| | - Koji Nishioka
- Department of Internal Medicine, Osaka Anti-Tuberculosis Association Osaka Fukujuji Hospital, Japan
| | - Hiromi Kimura
- Department of Internal Medicine, Osaka Anti-Tuberculosis Association Osaka Fukujuji Hospital, Japan
| | - Takafumi Yamamoto
- Department of Orthopedic Surgery, Osaka Anti-Tuberculosis Association Osaka Fukujuji Hospital, Japan
| | - Kiyoshi Komuta
- Department of Internal Medicine, Osaka Anti-Tuberculosis Association Osaka Fukujuji Hospital, Japan
| |
Collapse
|
|
14
|
Slouma M, Ben Dhia S, Dhahri R, Litaiem N, Metoui L, Gharsallah I, Louzir B. Cutaneous and rheumatological manifestations of reactive arthritis: A case report. Clin Case Rep 2022; 10:e6542. [PMID: 36381024 PMCID: PMC9637938 DOI: 10.1002/ccr3.6542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 09/23/2022] [Accepted: 10/15/2022] [Indexed: 11/09/2022] Open
Abstract
Reactive arthritis is a rare form of spondyloarthropathies occurring after genital or enteric infection. It is most often self-limited but can progress to chronic spondylarthritis. We report the case of a 30-year-old man who presented with acute arthritis occurring 2 months after an episode of urethral discharge. Physical examination revealed polyarthritis, dactylitis, sacroiliac joint involvement, and plantar papulosquamous plaques. The human leukocyte antigen B27 was positive. Detection of Chlamydia trachomatis and Gonococcus in the first catch urine specimen was negative. Hepatitis B and C, Chlamydia trachomatis, human immunodeficiency virus, and syphilis serologic test results were negative. Pelvic magnetic resonance imaging revealed left sacroiliitis. The patient was treated with antibiotics, diclofenac, and sulfasalazine. After 6 months of follow-up, a significant clinical improvement was obtained without remission, suggesting an evolution to chronic spondylarthritis. Diagnosis of Reactive arthritis is difficult since microbiologic examinations are commonly negative. This disease should be considered in patients with rheumatologic manifestations occurring after a urogenital or enteric infection, mainly when associated with skin manifestations and human leukocyte antigen B27.
Collapse
Affiliation(s)
- Maroua Slouma
- Department of RheumatologyMilitary HospitalTunisTunisia
- Tunis El Manar UniversityTunisTunisia
- Department of DermatologyCharles Nicolle HospitalTunisTunisia
| | - Siwar Ben Dhia
- Department of RheumatologyMilitary HospitalTunisTunisia
- Tunis El Manar UniversityTunisTunisia
- Department of DermatologyCharles Nicolle HospitalTunisTunisia
| | - Rim Dhahri
- Department of RheumatologyMilitary HospitalTunisTunisia
- Tunis El Manar UniversityTunisTunisia
- Department of DermatologyCharles Nicolle HospitalTunisTunisia
| | - Noureddine Litaiem
- Tunis El Manar UniversityTunisTunisia
- Department of DermatologyCharles Nicolle HospitalTunisTunisia
- Department of Internal MedicineMilitary HospitalTunisTunisia
| | - Leila Metoui
- Department of RheumatologyMilitary HospitalTunisTunisia
- Tunis El Manar UniversityTunisTunisia
- Department of DermatologyCharles Nicolle HospitalTunisTunisia
| | - Imen Gharsallah
- Department of RheumatologyMilitary HospitalTunisTunisia
- Tunis El Manar UniversityTunisTunisia
- Department of DermatologyCharles Nicolle HospitalTunisTunisia
| | - Bassem Louzir
- Tunis El Manar UniversityTunisTunisia
- Department of DermatologyCharles Nicolle HospitalTunisTunisia
- Department of Internal MedicineMilitary HospitalTunisTunisia
| |
Collapse
|
|
15
|
Haag A, Folk J. Man With Hip Pain. J Emerg Med 2022; 63:561-564. [DOI: 10.1016/j.jemermed.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 04/27/2022] [Accepted: 06/04/2022] [Indexed: 11/05/2022]
|
|
16
|
Waytz J, Dua A. A 58-Year-Old Man Presenting With Joint Pain and Confusion. Arthritis Care Res (Hoboken) 2022; 75:1189-1193. [PMID: 36161786 DOI: 10.1002/acr.25027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 12/30/2022]
Affiliation(s)
- Josh Waytz
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Anisha Dua
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| |
Collapse
|
|
17
|
Maikap D, Padhan P. Successful use of tofacitinib in reactive arthritis refractory to conventional therapies - a case series. Mod Rheumatol Case Rep 2022; 6:167-170. [PMID: 35024869 DOI: 10.1093/mrcr/rxab029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/20/2021] [Accepted: 08/18/2021] [Indexed: 06/14/2023]
Abstract
Reactive arthritis is an immune-mediated aseptic arthritis resulting from either genitourinary or gastrointestinal tract in a genetically susceptible host. It commonly presents as oligoarthritis of the lower limbs with or without extra-articular features such as urethritis and non-purulent conjunctivitis. Therapies include non steroidal anti inflammatory drugs (NSAIDs), conventional disease modifying anti-rheumatic drugs (DMARDs) and, rarely, biologics in severe cases. We report the successful use of tofacitinib in four cases of reactive arthritis who failed to respond to conventional therapies.
Collapse
Affiliation(s)
- Debashis Maikap
- Department of Clinical Immunology and Rheumatology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, Odisha 751024, India
| | - Prasanta Padhan
- Department of Clinical Immunology and Rheumatology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, Odisha 751024, India
| |
Collapse
|
|
18
|
Grando K, Nicastro LK, Tursi SA, De Anda J, Lee EY, Wong GCL, Tükel Ç. Phenol-Soluble Modulins From Staphylococcus aureus Biofilms Form Complexes With DNA to Drive Autoimmunity. Front Cell Infect Microbiol 2022; 12:884065. [PMID: 35646719 PMCID: PMC9131096 DOI: 10.3389/fcimb.2022.884065] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/04/2022] [Indexed: 12/15/2022] Open
Abstract
The bacterial amyloid curli, produced by Enterobacteriales including Salmonella species and Escherichia coli, is implicated in the pathogenesis of several complex autoimmune diseases. Curli binds to extracellular DNA, and these complexes drive autoimmunity via production of anti-double-stranded DNA autoantibodies. Here, we investigated immune activation by phenol-soluble modulins (PSMs), the amyloid proteins expressed by Staphylococcus species. We confirmed the amyloid nature of PSMs expressed by S. aureus using a novel specific amyloid stain, (E,E)-1-fluoro-2,5-bis(3-hydroxycarbonyl-4-hydroxy) styrylbenzene (FSB). Direct interaction of one of the S. aureus PSMs, PSMα3, with oligonucleotides promotes fibrillization of PSM amyloids and complex formation with bacterial DNA. Finally, utilizing a mouse model with an implanted mesh-associated S. aureus biofilm, we demonstrated that exposure to S. aureus biofilms for six weeks caused anti-double-stranded DNA autoantibody production in a PSM-dependent manner. Taken together, these results highlight how the presence of PSM-DNA complexes in S. aureus biofilms can induce autoimmune responses, and suggest an explanation for how bacterial infections trigger autoimmunity.
Collapse
Affiliation(s)
- Kaitlyn Grando
- Center for Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Lauren K. Nicastro
- Center for Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Sarah A. Tursi
- Center for Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Jaime De Anda
- Department of Bioengineering, Department of Chemistry and Biochemistry, California Nano Systems Institute, University of California, Los Angeles, Los Angeles, CA, United States
| | - Ernest Y. Lee
- Department of Bioengineering, Department of Chemistry and Biochemistry, California Nano Systems Institute, University of California, Los Angeles, Los Angeles, CA, United States
| | - Gerard C. L. Wong
- Department of Bioengineering, Department of Chemistry and Biochemistry, California Nano Systems Institute, University of California, Los Angeles, Los Angeles, CA, United States
| | - Çağla Tükel
- Center for Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
- *Correspondence: Çağla Tükel,
| |
Collapse
|
|
19
|
Jensen AK, Chatzidionysiou K, Torp CK, Sørensen AS, Tenstad HB, Schäfer VS, Kostine M, Jacobsen S, Leipe J, Kragstrup TW. Comparison of immune checkpoint inhibitor-induced arthritis and reactive arthritis to inform therapeutic strategy. Biomed Pharmacother 2022; 148:112687. [PMID: 35228067 DOI: 10.1016/j.biopha.2022.112687] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Immune checkpoint inhibitor-induced inflammatory arthritis (ICI-IA) is a relatively new disease entity caused by ICI agents during cancer therapy. Reactive arthritis (ReA) is a well-known disease entity caused by urogenital or gastrointestinal bacterial infection or pneumonia. In this sense, ICI-IA and ReA are both defined by a reaction to a well-specified causal event. As a result, comparing these diseases may help to determine therapeutic strategies. METHODS We compared ICI-IA and ReA with special focus on pharmacological management. Specifically regarding treatment, we conducted a literature search of studies published in the PubMed database. Inclusion criteria were studies on treatment with non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticoids (GC), or disease modifying antirheumatic drugs (DMARDs) in ICI-IA or ReA. During systematic selection, 21 studies evaluating ICI-IA and 14 studies evaluating ReA were included. RESULTS In ICI-IA, prospective and retrospective studies have shown effects of non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticoid (GC), sulfasalazine (SSZ), methotrexate (MTX), hydroxychloroquine (HCQ) and TNFi. In ReA, retrospective studies evaluated NSAIDs and GC. A randomized controlled trial reported the effect of SSZ, and a retrospective study reported the effect of MTX and SSZ in combination with tumor necrosis factor alpha inhibition (TNFi). For both entities, small case reports show treatment effects of interleukin 6 receptor inhibition (IL-6Ri). DISCUSSION This literature review identified both similarities and differences regarding the pathogenesis and clinical features of ReA and ICI-IA. Studies on treatment reported effectiveness of NSAIDs, GC, MTX, SSZ and TNFi in both diseases. Further, small case reports showed effects of IL-6Ri.
Collapse
Affiliation(s)
- Anders Kirkegaard Jensen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark; Department of Neurology, Sygehus Lillebælt, Kolding, Denmark
| | - Katerina Chatzidionysiou
- Department of Medicine Solna, Karolinska Institutet, Rheumatology Unit, Karolinska University Hospital, Stockholm, Sweden
| | | | | | | | - Valentin S Schäfer
- Clinic of Internal Medicine III, Department of Oncology, Hematology, Rheumatology and Clinical Immunology, University Hospital Bonn, Bonn, Germany
| | - Marie Kostine
- Department of Rheumatology, Bordeaux, University, Hospital, France
| | - Søren Jacobsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen, Denmark; Department of Rheumatology, Rigshospitalet, Copenhagen, Denmark
| | - Jan Leipe
- Division of Rheumatology, Department of Medicine V, University Hospital Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Germany.
| | - Tue Wenzel Kragstrup
- Department of Biomedicine, Aarhus University, Aarhus, Denmark; Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.
| |
Collapse
|
|
20
|
Kriegsmann M, Kriegsmann J. Synoviale Veränderungen bei Erkrankungen des rheumatologischen Formenkreises und Differenzialdiagnosen. ARTHROSKOPIE 2022. [PMCID: PMC8902900 DOI: 10.1007/s00142-022-00528-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Die Untersuchung synovialer Veränderungen kann zur Diagnose von Gelenkerkrankungen und von systemischen Erkrankungen beitragen. Die Domäne der histopathologischen Diagnostik stellt die Abgrenzung tumoröser von entzündlichen Läsionen dar. Daneben können Kristallarthropathien und bestimmte Stoffwechselerkrankungen sicher diagnostiziert werden. Unter dem histologischen Bild einer granulomatösen Synovialitis können neben einer mykobakteriellen Infektion Sarkoidosen und Fremdkörperreaktionen sowie selten genetische Erkrankungen beobachtet werden. Amyloidosen können auch in der Tunica synovialis subtypisiert werden. Molekulare Methoden erlauben die schnelle und sichere Diagnostik septischer Arthritiden und eine Keimtypisierung. Mittels dieser Methoden können auch reaktive Arthritiden klassifiziert werden, da auch hier häufig DNA oder RNA bestimmter Keime in Gewebe oder Gelenkflüssigkeit nachgewiesen werden kann. Die Diagnose der rheumatoiden Arthritis basiert auf den American College of Rheumatology(ACR)-Kriterien. Molekulare Methoden, wie die Mikro-RNA-Technologie oder proteomische Methoden können die Diagnose unterstützen.
Collapse
|
|
21
|
Rheumatoid Arthritis and Related Disorders. Fam Med 2022. [DOI: 10.1007/978-3-030-54441-6_120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
|
22
|
Dubey D, Kumar S, Rawat A, Guleria A, Kumari R, Ahmed S, Singh R, Misra R, Kumar D. NMR-Based Metabolomics Revealed the Underlying Inflammatory Pathology in Reactive Arthritis Synovial Joints. J Proteome Res 2021; 20:5088-5102. [PMID: 34661415 DOI: 10.1021/acs.jproteome.1c00620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Reactive arthritis (ReA) is an aseptic synovitis condition that often develops 2-4 weeks after a distant (extra-articular) infection with Chlamydia, Salmonella, Shigella, Campylobacter, and Yersinia species. The metabolic changes in the synovial fluid (SF) may serve as indicative markers to both improve the diagnostic accuracy and understand the underlying inflammatory pathology of ReA. With this aim, the metabolic profiles of SF collected from ReA (n = 58) and non-ReA, i.e., rheumatoid arthritis (RA, n = 21) and osteoarthritis (OA, n = 20) patients, respectively, were measured using NMR spectroscopy and compared using orthogonal partial least-squares discriminant analysis (OPLS-DA). The discriminatory metabolic features were further evaluated for their diagnostic potential using the receiver operating characteristic (ROC) curve analysis. Compared to RA, two (alanine and carnitine), and compared to OA, six (NAG, glutamate, glycerol, isoleucine, alanine, and glucose) metabolic features were identified as diagnostic biomarkers. We further demonstrated the impact of ReA synovitis condition on the serum metabolic profiles through performing a correlation analysis. The Pearson rank coefficient (r) was estimated for 38 metabolites (profiled in both SF and serum samples obtained in pair from ReA patients) and was found significantly positive for 71% of the metabolites (r ranging from 0.17 to 0.87).
Collapse
Affiliation(s)
- Durgesh Dubey
- Centre of Biomedical Research, Lucknow 226014, India.,Department of Clinical Immunology & Rheumatology, SGPGIMS, Lucknow 226014, India
| | - Sandeep Kumar
- Department of Clinical Immunology & Rheumatology, SGPGIMS, Lucknow 226014, India
| | - Atul Rawat
- Centre of Biomedical Research, Lucknow 226014, India
| | | | - Reena Kumari
- Department of Biochemistry, KGMU, Lucknow 226003, India
| | - Sakir Ahmed
- Department of Clinical Immunology & Rheumatology, SGPGIMS, Lucknow 226014, India.,Department of Clinical Immunology and Rheumatology, KIMS, Bhubaneswar 751024, India
| | - Rajeev Singh
- Regional Medical Research Center, Gorakhpur 273013, India
| | - Ramnath Misra
- Department of Clinical Immunology & Rheumatology, SGPGIMS, Lucknow 226014, India.,Department of Clinical Immunology and Rheumatology, KIMS, Bhubaneswar 751024, India
| | - Dinesh Kumar
- Centre of Biomedical Research, Lucknow 226014, India
| |
Collapse
|
|
23
|
Santacruz JC, Londoño J, Santos AM, Arzuaga A, Mantilla MJ. Extra-Articular Manifestations in Reactive Arthritis due to COVID-19. Cureus 2021; 13:e18620. [PMID: 34765373 PMCID: PMC8574203 DOI: 10.7759/cureus.18620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2021] [Indexed: 01/19/2023] Open
Abstract
Reactive arthritis (ReA) is defined as arthritis that arises after infection, where pathogens cannot grow in the affected joints. Formerly, the clinical triad of postinfectious arthritis, urethritis, and conjunctivitis was called Reiter's syndrome; however, these clinical signs only represented a subset of patients with ReA. Due to the great diversity of its manifestations, its diagnosis is a challenge and can be overlooked in clinical practice. Additionally, it is associated with a variety of extra-articular manifestations that may be present either in the acute or chronic phase of the disease. Despite the cardinal clinical presentation characteristics of ReA, no case has been described in the literature that is diagnosed by the presence of classic extra-articular manifestations without objective joint involvement after COVID-19 infection. This report describes the case of a female patient in her third decade of life with an unusual presentation of ReA and focuses on her extra-articular manifestations.
Collapse
Affiliation(s)
| | - John Londoño
- Spondyloarthropathies Research Group, Universidad de la Sabana, Chía, COL
| | - Ana María Santos
- Spondyloarthropathies Research Group, Universidad de la Sabana, Chía, COL
| | - Angelo Arzuaga
- Rheumatology Department, Universidad Militar Nueva Granada, Bogotá, COL
| | | |
Collapse
|
|
24
|
Abstract
Reactive arthritis (ReA) is a form of inflammatory arthritis triggered by a remote antecedent infection, usually in the genitourinary or gastrointestinal tract. It is part of the spondyloarthropathy (SpA) spectrum, an umbrella term for a group of distinct conditions with shared clinical features. Typically, it presents with an asymmetric oligoarthritis of the lower limb joints, and patients may also have sacroiliitis, enthesitis and dactylitis. Other features often seen include anterior uveitis, urethritis and skin manifestations such as pustular lesions on the plantar areas. Although ReA was characterised initially as a sterile arthritis, the detection of metabolically active Chlamydia species in the joint fluid of some affected patients has generated further questions on the pathophysiology of this condition. There are no formal diagnostic criteria, and the diagnosis is mainly clinical. HLA-B27 can support the diagnosis in the correct clinical context, and serves as a prognostic indicator. The majority of patients have a self-limiting course, but some develop chronic SpA and require immunomodulatory therapy.
Collapse
Affiliation(s)
- Ameen Jubber
- Department of Rheumatology, University Hospitals of Leicester NHS Trust, Leicester, LE1 5WW, UK,
| | - Arumugam Moorthy
- Department of Rheumatology, University Hospitals of Leicester NHS Trust, Leicester; College of Life Sciences, University of Leicester, Leicester
| |
Collapse
|
|
25
|
Liao CH, Lyu SY, Chen HC, Chang DM, Lu CC. Thymoma-Related Paraneoplastic Syndrome Mimicking Reactive Arthritis. ACTA ACUST UNITED AC 2021; 57:medicina57090932. [PMID: 34577855 PMCID: PMC8465497 DOI: 10.3390/medicina57090932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 09/03/2021] [Accepted: 09/03/2021] [Indexed: 01/31/2023]
Abstract
Background and Objectives: Thymomas are associated with a high frequency of paraneoplastic manifestations. Paraneoplastic syndrome (PNS) with thymoma presents a challenge to clinicians because of the need to decipher the association between the presenting symptoms and the underlying tumor. The condition most commonly noted in patients with PNS with thymoma is myasthenia gravis. Other common autoimmune diseases that may present as PNS include systemic lupus erythematosus, pure red cell aplasia, and Good syndrome. Seventy-six percent of patients with PNS-associated thymoma experience resolution of PNS after curing thymoma. Materials and Methods: A 37-year-old man with a two-month fever accompanied by polyarthritis accidently found thymoma after contrast computed tomography scans of his chest. He accepted Video assisted thoracoscopic surgery with resection of thymoma. Results: Fever and polyarthritis resolved after operation but recurred in five days due to cytomegalovirus viremia, which might be predisposed by previous antibiotics treatment before the diagnosis of thymoma. Conclusion: Patients with a thymoma also have a high frequency of PNS, and the most frequent condition found in patients with PNS-associated thymoma is myasthenia gravis. Fever with polyarthritis has been rarely reported as a symptom of PNS-associated thymoma. Here we reported an unusual case of PNS mimicking reactive arthritis with thymoma, as diagnosed based on the patient’s clinical progression, imaging examination, and laboratory tests. The patient died of his comorbidities, and his death may have been related to long-term antibiotic use and consequent intestinal dysbiosis. This challenging case may help to inform clinicians of the need for detailed work-up of fever with unknown origin in the presence of chronic polyarthritis to prevent the overdiagnosis of inflammatory arthritis or rheumatic disease and avoid further comorbidities. Detailed work-up should include the patient’s history of infections, inflammation, and malignant or nonmalignant tumors.
Collapse
Affiliation(s)
- Chang-Hung Liao
- Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan;
| | - Sin-Yi Lyu
- Division of Radiology, Tri-Service General Hospital Keelung Branch, National Defense Medical Center, Taipei 114, Taiwan;
| | - Hsiang-Cheng Chen
- Division of Rheumatology/Immunology and Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan; (H.-C.C.); (D.-M.C.)
| | - Deh-Ming Chang
- Division of Rheumatology/Immunology and Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan; (H.-C.C.); (D.-M.C.)
- Division of Allergy, Immunology, Rheumatology, Department of Internal Medicine, Taipei Veteran General Hospital, Taipei 114, Taiwan
| | - Chun-Chi Lu
- Division of Rheumatology/Immunology and Allergy, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan; (H.-C.C.); (D.-M.C.)
- Department of Pathology, University of Washington, Seattle, WA 98195, USA
- Correspondence:
| |
Collapse
|
|
26
|
Pogreba-Brown K, Austhof E, Tang X, Trejo MJ, Owusu-Dommey A, Boyd K, Armstrong A, Schaefer K, Bazaco MC, Batz M, Riddle M, Porter C. Enteric Pathogens and Reactive Arthritis: Systematic Review and Meta-Analyses of Pathogen-Associated Reactive Arthritis. Foodborne Pathog Dis 2021; 18:627-639. [PMID: 34255548 DOI: 10.1089/fpd.2020.2910] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The objective of this systematic review and meta-analysis was to estimate the proportion of postinfectious reactive arthritis (ReA) after bacterial enteric infection from one of four selected pathogens. We collected studies from PubMed, Web of Science, and Embase, which assessed the proportion of postinfectious ReA published from January 1, 2000 to April 1, 2018. Papers were screened independently by title, abstract, and full text; papers in English, Spanish, and Portuguese utilizing a case-control (CC) or cohort study design, with a laboratory confirmed or probable acute bacterial enteric infection and subsequent ReA, were included. The proportion of ReA cases was pooled between and across pathogens. Factors that can induce study heterogeneity were explored using univariate meta-regression, including region, sample size, study design, and ReA case ascertainment. Twenty-four articles were included in the final review. The estimated percentage of cases across studies describing Campylobacter-associated ReA (n = 11) was 1.71 (95% confidence interval [CI] 0.49-5.84%); Salmonella (n = 17) was 3.9 (95% CI 1.6-9.1%); Shigella (n = 6) was 1.0 (95% CI 0.2-4.9%); and Yersinia (n = 7) was 3.4 (95% CI 0.8-13.7%). Combining all four pathogens, the estimated percentage of cases that developed ReA was 2.6 (95% CI 1.5-4.7%). Due to high heterogeneity reflected by high I2 values, results should be interpreted with caution. However, the pooled proportion developing ReA from studies with sample sizes (N) <1000 were higher compared with N > 1000 (6% vs. 0.3%), retrospective cohort studies were lower (1.1%) compared with CC or prospective cohorts (6.8% and 5.9%, respectively), and those where ReA cases are identified through medical record review were lower (0.3%) than those identified by a specialist (3.9%) or self-report (12%). The estimated percentage of people who developed ReA after infection with Campylobacter, Salmonella, Shigella, or Yersinia is relatively low (2.6). In the United States, this estimate would result in 84,480 new cases of ReA annually.
Collapse
Affiliation(s)
- Kristen Pogreba-Brown
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, USA
| | - Erika Austhof
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, USA
| | - Xin Tang
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, USA
| | - Mario J Trejo
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, USA
| | - Ama Owusu-Dommey
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, USA
| | - Kylie Boyd
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, USA
| | - Alexandra Armstrong
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, USA
| | - Kenzie Schaefer
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, USA
| | | | - Michael Batz
- U.S. Food and Drug Administration, College Park, Maryland, USA
| | - Mark Riddle
- Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, Nevada, USA
| | - Chad Porter
- Naval Medical Research Center, Silver Spring, Maryland, USA
| |
Collapse
|
|
27
|
Zeidler H, Hudson AP. Reactive Arthritis Update: Spotlight on New and Rare Infectious Agents Implicated as Pathogens. Curr Rheumatol Rep 2021; 23:53. [PMID: 34196842 PMCID: PMC8247622 DOI: 10.1007/s11926-021-01018-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 12/11/2022]
Abstract
Purpose of Review This article presents a comprehensive narrative review of reactive arthritis (ReA) with focus on articles published between 2018 and 2020. We discuss the entire spectrum of microbial agents known to be the main causative agents of ReA, those reported to be rare infective agents, and those reported to be new candidates causing the disease. The discussion is set within the context of changing disease terminology, definition, and classification over time. Further, we include reports that present at least a hint of effective antimicrobial therapy for ReA as documented in case reports or in double-blind controlled studies. Additional information is included on microbial products detected in the joint, as well as on the positivity of HLA-B27. Recent Findings Recent reports of ReA cover several rare causative microorganism such as Neisseria meningitides, Clostridium difficile, Escherichia coli, Hafnia alvei, Blastocytosis, Giardia lamblia, Cryptosporidium, Cyclospora cayetanensis, Entamoeba histolytica/dispar, Strongyloides stercoralis, β-haemolytic Streptococci, Mycobacterium tuberculosis, Mycoplasma pneumoniae, Mycobacterium bovis bacillus Calmette-Guerin, and Rickettsia rickettsii. The most prominent new infectious agents implicated as causative in ReA are Staphylococcus lugdunensis, placenta- and umbilical cord–derived Wharton’s jelly, Rothia mucilaginosa, and most importantly the SARS-CoV-2 virus. Summary In view of the increasingly large spectrum of causative agents, diagnostic consideration for the disease must include the entire panel of post-infectious arthritides termed ReA. Diagnostic procedures cannot be restricted to the well-known HLA-B27-associated group of ReA, but must also cover the large number of rare forms of arthritis following infections and vaccinations, as well as those elicited by the newly identified members of the ReA group summarized herein. Inclusion of these newly identified etiologic agents must necessitate increased research into the pathogenic mechanisms variously involved, which will engender important insights for treatment and management of ReA. Supplementary Information The online version contains supplementary material available at 10.1007/s11926-021-01018-6.
Collapse
Affiliation(s)
- Henning Zeidler
- Division of Clinical Immunology and Rheumatology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | - Alan P Hudson
- Department of Biochemistry, Microbiology, and Immunology, Wayne State University School of Medicine, Detroit, MI, USA
| |
Collapse
|
|
28
|
Reinholz A, Mannuru D, Bande D, Matta A. Reactive arthritis: an unusual presentation of acute Clostridioides difficile colitis. BMJ Case Rep 2021; 14:14/4/e240890. [PMID: 33795278 DOI: 10.1136/bcr-2020-240890] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
A 20-year-old Caucasian man with a history of psoriasis presented to the emergency department due to a 2-week history of severe polyarthralgia and a 3-week history of non-bloody diarrhoea. The initial workup 2 days prior in an urgent care clinic returned negative for all enteric pathogens including Clostridioides difficile nucleic acid amplification test. Investigations revealed colitis on CT and pseudomembranous colitis on colonoscopy. The aspirate returned positive for C. difficile toxin. Tissue biopsies of the ascending, transverse, sigmoid colon and rectum were negative for chronicity to suggest inflammatory bowel disease with extraintestinal manifestation as the aetiology of polyarthralgia, which had been the most likely differential diagnosis until that point. The biopsy confirmed the diagnosis of reactive arthritis in the setting of C. difficile colitis. The patient improved on treatment with naproxen and was referred to rheumatology where he was found to be HLA-B27 positive.
Collapse
Affiliation(s)
- Anna Reinholz
- Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA
| | - Devendranath Mannuru
- Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA.,Internal Medicine, Sanford Medical Center, Fargo, North Dakota, USA
| | - Dinesh Bande
- Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA.,Internal Medicine, Sanford Medical Center, Fargo, North Dakota, USA
| | - Abhisnek Matta
- Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA .,Internal Medicine, Sanford Medical Center, Fargo, North Dakota, USA
| |
Collapse
|
|
29
|
Gupta V, Mohta P, Sharma VK, Khanna N. A retrospective case series of 12 patients with chronic reactive arthritis with emphasis on treatment outcome with biologics. Indian J Dermatol Venereol Leprol 2021; 87:227-234. [DOI: 10.4103/ijdvl.ijdvl_519_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 11/01/2018] [Indexed: 01/31/2023]
Abstract
Background:
Patients with reactive arthritis frequently present to dermatologists. However, there is paucity of information regarding its clinical aspects and management in dermatological literature.
Objective:
To review the clinical features and management of patients with chronic reactive arthritis admitted to the dermatology department of a teaching hospital.
Methods:
This was a retrospective analysis of patients with reactive arthritis admitted to the Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India from January 2016 to February 2018.
Results:
There were 12 males (disease duration 9–180 months). Biologics were used in 9 (75%) patients on 16 different occasions, the most frequent being infliximab (n = 10 times), followed by adalimumab (n = 3), etanercept, secukinumab and itolizumab (n = 1 each), in combination with other systemic agents. Response rate with treatment regimens including biologics (69% responders, 31% partial responders) was statistically significantly better than those without biologics (27% responders, 46% partial responders, 27% nonresponders; P = 0.036), using a composite measure assessing improvement in skin and joint symptoms. Biologics were discontinued on 50% of the occasions, after a median of 3.5 months (range 1.5–7.5 months) because of satisfactory response (n = 4), therapeutic fatigue (n = 3) or adverse event (n = 1). After biologic discontinuation, the response was sustained for a median of 5 months (range 3–6 months) before disease exacerbation. The number of treatment switches increased with the follow-up duration (median three switches per patient, range 1–8). The median follow-up duration was 10.5 months (range 4–76 months).
Conclusion:
Biologics produce rapid improvement in skin and joint symptoms in chronic reactive arthritis, but the response is not long-lasting. Patients with chronic reactive arthritis have a waxing and waning course despite regular treatment.
Limitations:
The limitations are retrospective design, small sample size and lack of a validated outcome measure.
Collapse
|
|
30
|
Treatment of reactive arthritis with biological agents: a review. Biosci Rep 2021; 40:222065. [PMID: 32039436 PMCID: PMC7033307 DOI: 10.1042/bsr20191927] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 02/02/2020] [Accepted: 02/05/2020] [Indexed: 12/31/2022] Open
Abstract
The pathogenesis of reactive arthritis (ReA) has not been fully elucidated. In recent years, many researchers have confirmed that multiple cytokines are involved in the occurrence and development of ReA. Although ReA is self-limiting, it is still incurable for some patients who have no or a weak response to traditional drugs, such as non-steroidal anti-inflammatory agents, glucocorticoids and immunosuppressive agents. This is called refractory reactive arthritis. Currently, there is insufficient evidences for the treatment of refractory ReA with biological agents, though biological agents against cytokines have been developed over the past few years. This review summarizes the current development of clinical treatments of ReA with biological agents, which provides future investigations on refractory ReA with more evidence and references.
Collapse
|
|
31
|
Miller AL, Bessho S, Grando K, Tükel Ç. Microbiome or Infections: Amyloid-Containing Biofilms as a Trigger for Complex Human Diseases. Front Immunol 2021; 12:638867. [PMID: 33717189 PMCID: PMC7952436 DOI: 10.3389/fimmu.2021.638867] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/09/2021] [Indexed: 12/14/2022] Open
Abstract
The human microbiota is the community of microorganisms that live upon or within their human host. The microbiota consists of various microorganisms including bacteria, fungi, viruses, and archaea; the gut microbiota is comprised mostly of bacteria. Many bacterial species within the gut microbiome grow as biofilms, which are multicellular communities embedded in an extracellular matrix. Studies have shown that the relative abundances of bacterial species, and therefore biofilms and bacterial byproducts, change during progression of a variety of human diseases including gastrointestinal, autoimmune, neurodegenerative, and cancer. Studies have shown the location and proximity of the biofilms within the gastrointestinal tract might impact disease outcome. Gram-negative enteric bacteria secrete the amyloid curli, which makes up as much as 85% of the extracellular matrix of enteric biofilms. Curli mediates cell-cell attachment and attachment to various surfaces including extracellular matrix components such as fibronectin and laminin. Structurally, curli is strikingly similar to pathological and immunomodulatory human amyloids such as amyloid-β, which has been implicated in Alzheimer's disease, α-synuclein, which is involved in Parkinson's disease, and serum amyloid A, which is secreted during the acute phase of inflammation. The immune system recognizes both bacterial amyloid curli and human amyloids utilizing the same receptors, so curli also induces inflammation. Moreover, recent work indicates that curli can participate in the self-assembly process of pathological human amyloids. Curli is found within biofilms of commensal enteric bacteria as well as invasive pathogens; therefore, evidence suggests that curli contributes to complex human diseases. In this review, we summarize the recent findings on how bacterial biofilms containing curli participate in the pathological and immunological processes in gastrointestinal diseases, systemic autoimmune diseases, and neurodegenerative diseases.
Collapse
Affiliation(s)
- Amanda L Miller
- Department of Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Shingo Bessho
- Department of Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Kaitlyn Grando
- Department of Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Çagla Tükel
- Department of Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| |
Collapse
|
|
32
|
Sureja NP, Nandamuri D. Reactive arthritis after SARS-CoV-2 infection. Rheumatol Adv Pract 2021; 5:rkab001. [PMID: 33615130 PMCID: PMC7882147 DOI: 10.1093/rap/rkab001] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 01/06/2021] [Indexed: 12/31/2022] Open
Affiliation(s)
| | - Dilip Nandamuri
- Department of Internal Medicine, Star Hospitals, Hyderabad, India
| |
Collapse
|
|
33
|
Hospach T, Minden K, Huppertz HI. Reaktive Arthritis – ein Update. Monatsschr Kinderheilkd 2020. [DOI: 10.1007/s00112-020-01046-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
|
34
|
Ono K, Kishimoto M, Shimasaki T, Uchida H, Kurai D, Deshpande GA, Komagata Y, Kaname S. Reactive arthritis after COVID-19 infection. RMD Open 2020; 6:rmdopen-2020-001350. [PMID: 32763956 PMCID: PMC7722270 DOI: 10.1136/rmdopen-2020-001350] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/10/2020] [Accepted: 07/18/2020] [Indexed: 12/13/2022] Open
Abstract
Reactive arthritis (ReA) is typically preceded by sexually transmitted disease or gastrointestinal infection. An association has also been reported with bacterial and viral respiratory infections. Herein, we report the first case of ReA after the he severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This male patient is in his 50s who was admitted with COVID-19 pneumonia. On the second day of admission, SARS-CoV-2 PCR was positive from nasopharyngeal swab specimen. Despite starting standard dose of favipiravir, his respiratory condition deteriorated during hospitalisation. On the fourth hospital day, he developed acute respiratory distress syndrome and was intubated. On day 11, he was successfully extubated, subsequently completing a 14-day course of favipiravir. On day 21, 1 day after starting physical therapy, he developed acute bilateral arthritis in his ankles, with mild enthesitis in his right Achilles tendon, without rash, conjunctivitis, or preceding diarrhoea or urethritis. Arthrocentesis of his left ankle revealed mild inflammatory fluid without monosodium urate or calcium pyrophosphate crystals. Culture of synovial fluid was negative. Plain X-rays of his ankles and feet showed no erosive changes or enthesophytes. Tests for syphilis, HIV, anti-streptolysin O (ASO), Mycoplasma, Chlamydia pneumoniae, antinuclear antibody, rheumatoid factor, anticyclic citrullinated peptide antibody and Human Leukocyte Antigen-B27 (HLA-B27) were negative. Gonococcal and Chlamydia trachomatis urine PCR were also negative. He was diagnosed with ReA. Nonsteroidal Anti-Inflammatory Drug (NSAID)s and intra-articular corticosteroid injection resulted in moderate improvement.
Collapse
Affiliation(s)
- Keisuke Ono
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Shinkawa, Mitaka-shi, Tokyo, Japan
| | - Mitsumasa Kishimoto
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Shinkawa, Mitaka-shi, Tokyo, Japan
| | - Teppei Shimasaki
- Department of Infectious Disease, Kyorin University School of Medicine, Shinkawa, Mitaka-shi, Tokyo, Japan
| | - Hiroko Uchida
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Shinkawa, Mitaka-shi, Tokyo, Japan
| | - Daisuke Kurai
- Department of Infectious Disease, Kyorin University School of Medicine, Shinkawa, Mitaka-shi, Tokyo, Japan
| | - Gautam A Deshpande
- Department of Internal Medicine, University of Hawaii at Manoa John A Burns School of Medicine, Honolulu, Hawaii, USA
| | - Yoshinori Komagata
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Shinkawa, Mitaka-shi, Tokyo, Japan
| | - Shinya Kaname
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, Shinkawa, Mitaka-shi, Tokyo, Japan
| |
Collapse
|
|
35
|
Abstract
We report the case of a 37-year-old female who presented for evaluation of acute 10/10 right hand pain, 12 days after testing positive for SARS-CoV2. The patient was admitted to the hospital due to the severity of her pain. As an inpatient, extensive workup by the medicine team and rheumatology revealed no structural, vascular, or neurogenic cause of her pain. The patient's blood work was unremarkable for elevations in lyme serology, antinuclear antibody (ANA), rheumatoid factor, and uric acid. It was determined that the cause of her pain was most likely reactive arthritis (ReA) secondary to her SARS-CoV2 infection. She was treated with voltaren gel, neurontin, and oral dilaudid as needed and discharged. Upon follow-up, her pain improved and she was prescribed a wrist splint, ultram, and occupational therapy for perceived wrist tendinitis. To our knowledge, this is the first description of a case of ReA caused by the SARS-CoV2 virus.
Collapse
Affiliation(s)
- Zach Danssaert
- Physical Medicine and Rehabilitation, Reading Health System, Reading Hospital, Reading, USA
| | - George Raum
- Physical Medicine and Rehabilitation, Philadelphia College of Osteopathic Medicine, Philadelphia, USA
| | - Somkiat Hemtasilpa
- Physical Medicine and Rehabilitation, Reading Hospital Rehabilitation at Wyomissing, Reading, USA
| |
Collapse
|
|
36
|
Miller AL, Pasternak JA, Medeiros NJ, Nicastro LK, Tursi SA, Hansen EG, Krochak R, Sokaribo AS, MacKenzie KD, Palmer MB, Herman DJ, Watson NL, Zhang Y, Wilson HL, Wilson RP, White AP, Tükel Ç. In vivo synthesis of bacterial amyloid curli contributes to joint inflammation during S. Typhimurium infection. PLoS Pathog 2020; 16:e1008591. [PMID: 32645118 PMCID: PMC7347093 DOI: 10.1371/journal.ppat.1008591] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 05/01/2020] [Indexed: 12/16/2022] Open
Abstract
Reactive arthritis, an autoimmune disorder, occurs following gastrointestinal infection with invasive enteric pathogens, such as Salmonella enterica. Curli, an extracellular, bacterial amyloid with cross beta-sheet structure can trigger inflammatory responses by stimulating pattern recognition receptors. Here we show that S. Typhimurium produces curli amyloids in the cecum and colon of mice after natural oral infection, in both acute and chronic infection models. Production of curli was associated with an increase in anti-dsDNA autoantibodies and joint inflammation in infected mice. The negative impacts on the host appeared to be dependent on invasive systemic exposure of curli to immune cells. We hypothesize that in vivo synthesis of curli contributes to known complications of enteric infections and suggest that cross-seeding interactions can occur between pathogen-produced amyloids and amyloidogenic proteins of the host. Our manuscript focuses on curli, a ‘functional amyloid’ produced by Salmonella as well as other enteric bacteria. We present the first biochemical evidence that these fibers are produced in the gastrointestinal tract of mice after oral infection, the natural route for Salmonella infections. This finding is significant because of the immune impacts on the host; we show that curli cause an increase in autoimmunity and inflammation in the knee joints of infected mice. Reactive arthritis is a known autoimmune complication after enteric infections and our results indicate that presence of curli in the gut provides a novel linchpin of pathogenesis. As curli or curli-like amyloids are also produced by the commensal bacteria, it is possible that the unintended release of amyloids produced by the microbiota could trigger similar autoimmune reactions. Finally, our work provides conceptual evidence for the possibility of cross-seeding between bacterial amyloids like curli and human amyloids involved in amyloid-associated diseases such as Alzheimer’s Disease via the gut microbiome or infections.
Collapse
Affiliation(s)
- Amanda L. Miller
- Department of Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - J. Alex Pasternak
- Vaccine and Infectious Disease Organization-International Vaccine Centre, Saskatoon, Saskatchewan, Canada
| | - Nicole J. Medeiros
- Department of Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Lauren K. Nicastro
- Department of Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Sarah A. Tursi
- Department of Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Elizabeth G. Hansen
- Vaccine and Infectious Disease Organization-International Vaccine Centre, Saskatoon, Saskatchewan, Canada
- Department of Biochemistry, Microbiology and Immunology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Ryan Krochak
- Vaccine and Infectious Disease Organization-International Vaccine Centre, Saskatoon, Saskatchewan, Canada
- Department of Biochemistry, Microbiology and Immunology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Akosiererem S. Sokaribo
- Vaccine and Infectious Disease Organization-International Vaccine Centre, Saskatoon, Saskatchewan, Canada
- Department of Biochemistry, Microbiology and Immunology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Keith D. MacKenzie
- Vaccine and Infectious Disease Organization-International Vaccine Centre, Saskatoon, Saskatchewan, Canada
- Department of Biochemistry, Microbiology and Immunology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Melissa B. Palmer
- Vaccine and Infectious Disease Organization-International Vaccine Centre, Saskatoon, Saskatchewan, Canada
- Department of Biochemistry, Microbiology and Immunology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Dakoda J. Herman
- Vaccine and Infectious Disease Organization-International Vaccine Centre, Saskatoon, Saskatchewan, Canada
- Department of Biochemistry, Microbiology and Immunology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Nikole L. Watson
- Vaccine and Infectious Disease Organization-International Vaccine Centre, Saskatoon, Saskatchewan, Canada
- Department of Biochemistry, Microbiology and Immunology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Yi Zhang
- Department of Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Heather L. Wilson
- Vaccine and Infectious Disease Organization-International Vaccine Centre, Saskatoon, Saskatchewan, Canada
| | - R. Paul Wilson
- Department of Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
| | - Aaron P. White
- Vaccine and Infectious Disease Organization-International Vaccine Centre, Saskatoon, Saskatchewan, Canada
- Department of Biochemistry, Microbiology and Immunology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
- * E-mail: (APW); (CT)
| | - Çagla Tükel
- Department of Microbiology and Immunology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America
- * E-mail: (APW); (CT)
| |
Collapse
|
|
37
|
Fakih O, Biguenet A, Gallais Sérézal I, Aubin F. Cutaneous manifestation of reactive arthritis. Joint Bone Spine 2020; 87:658. [PMID: 32622043 DOI: 10.1016/j.jbspin.2020.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 06/04/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Olivier Fakih
- Service de Dermatologie, 3, boulevard Fleming, 25000 Besançon, France
| | - Adrien Biguenet
- Department of infectious diseases, Besançon University hospital, Besançon, France
| | | | - François Aubin
- Service de Dermatologie, 3, boulevard Fleming, 25000 Besançon, France.
| |
Collapse
|
|
38
|
Vinci C, Infantino M, Raturi S, Tindell A, Topping LM, Strollo R, Amital H, Shoenfeld Y, Gertel S, Grossi V, Manfredi M, Rutigliano IM, Bandinelli F, Li Gobbi F, Damiani A, Pozzilli P, Mcinnes IB, Goodyear CS, Benucci M, Nissim A. Immunoglobulin A antibodies to oxidized collagen type II as a potential biomarker for the stratification of spondyloarthritis from rheumatoid arthritis. Scand J Rheumatol 2020; 49:281-291. [PMID: 32314641 DOI: 10.1080/03009742.2020.1713395] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The discovery of diseased tissue-specific neoantigens offers the opportunity to develop important disease tissue-specific biomarkers that can help in the prediction, diagnosis, and stratification of diseases. This opportunity is specifically significant for autoimmune diseases where diagnostic biomarkers are not available. Inflammatory autoimmune diseases are commonly associated with local generation of large amounts of reactive oxidants. We have previously identified oxidative post-translationally modified (oxPTM) tissue-specific neoantigens in rheumatoid arthritis (RA) and type 1 diabetes that elicit an immune response. In the current study, we studied the presence and clinical significance of antibodies to oxPTM collagen type II (CII) in patients with spondyloarthritis (SpA). METHOD Levels of antibodies specific to native CII and oxPTM-CII were assessed by enzyme-linked immunosorbent assay. RESULTS Immunoglobulin G (IgG) binding to oxPTM-CII was observed in 52%, 83%, and 28% of serum samples from patients with axial spondyloarthritis (axSpA), RA, and psoriatic arthritis (PsA), respectively. Importantly, while strong IgA anti-oxPTM-CII responses were detected in axSpA and PsA patients, with 47% and 84% respective binders, no IgA anti-oxPTM-CII was detected in RA patients. IgA anti-oxPTM-CII reactivity in axSpA patients treated with biologics was higher and more frequent, with 85% binders compared to 9% binders in patients treated with synthetic disease-modifying anti-rheumatic drugs. CONCLUSION Our data imply that SpA and PsA are associated with the presence of antibodies to oxPTM-CII, suggesting that there may be a humoral component that may distinguish patients with SpA from RA. Our approach could be adapted to other diseases, particularly to inflammatory autoimmune diseases.
Collapse
Affiliation(s)
- C Vinci
- Biochemical Pharmacology, William Harvey Research Institute, Queen Mary University of London , London, UK.,Department of Endocrinology and Diabetes, Campus Biomedico , Rome, Italy
| | - M Infantino
- Immunology and Allergology Laboratory Unit, S.Giovanni di Dio Hospital , Florence, Italy
| | - S Raturi
- Biochemical Pharmacology, William Harvey Research Institute, Queen Mary University of London , London, UK
| | - A Tindell
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow , Glasgow, UK
| | - L M Topping
- Biochemical Pharmacology, William Harvey Research Institute, Queen Mary University of London , London, UK
| | - R Strollo
- Department of Endocrinology and Diabetes, Campus Biomedico , Rome, Italy
| | - H Amital
- Department of Internal Medicine B and Zabludowicz Center for Autoimmune Diseases, Sheba Medical Centre , Ramat Gan, Israel
| | - Y Shoenfeld
- Department of Internal Medicine B and Zabludowicz Center for Autoimmune Diseases, Sheba Medical Centre , Ramat Gan, Israel
| | - S Gertel
- Department of Internal Medicine B and Zabludowicz Center for Autoimmune Diseases, Sheba Medical Centre , Ramat Gan, Israel
| | - V Grossi
- Immunology and Allergology Laboratory Unit, S.Giovanni di Dio Hospital , Florence, Italy
| | - M Manfredi
- Immunology and Allergology Laboratory Unit, S.Giovanni di Dio Hospital , Florence, Italy
| | - I M Rutigliano
- Rheumatology Unit, Sab.Giovanni di Dio Hospital , Florence, Italy
| | - F Bandinelli
- Rheumatology Unit, Sab.Giovanni di Dio Hospital , Florence, Italy
| | - F Li Gobbi
- Rheumatology Unit, Sab.Giovanni di Dio Hospital , Florence, Italy
| | - A Damiani
- Rheumatology Unit, Sab.Giovanni di Dio Hospital , Florence, Italy
| | - P Pozzilli
- Department of Endocrinology and Diabetes, Campus Biomedico , Rome, Italy
| | - I B Mcinnes
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow , Glasgow, UK
| | - C S Goodyear
- Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow , Glasgow, UK
| | - M Benucci
- Rheumatology Unit, Sab.Giovanni di Dio Hospital , Florence, Italy
| | - A Nissim
- Biochemical Pharmacology, William Harvey Research Institute, Queen Mary University of London , London, UK
| |
Collapse
|
|
39
|
Ellwanger JH, Kaminski VDL, Rodrigues AG, Kulmann-Leal B, Chies JAB. CCR5 and CCR5Δ32 in bacterial and parasitic infections: Thinking chemokine receptors outside the HIV box. Int J Immunogenet 2020; 47:261-285. [PMID: 32212259 DOI: 10.1111/iji.12485] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/02/2020] [Accepted: 03/06/2020] [Indexed: 12/14/2022]
Abstract
The CCR5 molecule was reported in 1996 as the main HIV-1 co-receptor. In that same year, the CCR5Δ32 genetic variant was described as a strong protective factor against HIV-1 infection. These findings led to extensive research regarding the CCR5, culminating in critical scientific advances, such as the development of CCR5 inhibitors for the treatment of HIV infection. Recently, the research landscape surrounding CCR5 has begun to change. Different research groups have realized that, since CCR5 has such important effects in the chemokine system, it could also affect other different physiological systems. Therefore, the effect of reduced CCR5 expression due to the presence of the CCR5Δ32 variant began to be further studied. Several studies have investigated the role of CCR5 and the impacts of CCR5Δ32 on autoimmune and inflammatory diseases, various types of cancer, and viral diseases. However, the role of CCR5 in diseases caused by bacteria and parasites is still poorly understood. Therefore, the aim of this article is to review the role of CCR5 and the effects of CCR5Δ32 on bacterial (brucellosis, osteomyelitis, pneumonia, tuberculosis and infection by Chlamydia trachomatis) and parasitic infections (toxoplasmosis, leishmaniasis, Chagas disease and schistosomiasis). Basic information about each of these infections was also addressed. The neglected role of CCR5 in fungal disease and emerging studies regarding the action of CCR5 on regulatory T cells are briefly covered in this review. Considering the "renaissance of CCR5 research," this article is useful for updating researchers who develop studies involving CCR5 and CCR5Δ32 in different infectious diseases.
Collapse
Affiliation(s)
- Joel Henrique Ellwanger
- Laboratory of Immunobiology and Immunogenetics, Department of Genetics, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, Brazil
| | - Valéria de Lima Kaminski
- Laboratory of Immunobiology and Immunogenetics, Department of Genetics, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, Brazil
| | - Andressa Gonçalves Rodrigues
- Laboratory of Immunobiology and Immunogenetics, Department of Genetics, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, Brazil
| | - Bruna Kulmann-Leal
- Laboratory of Immunobiology and Immunogenetics, Department of Genetics, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, Brazil
| | - José Artur Bogo Chies
- Laboratory of Immunobiology and Immunogenetics, Department of Genetics, Universidade Federal do Rio Grande do Sul - UFRGS, Porto Alegre, Brazil
| |
Collapse
|
|
40
|
Thomas KM, de Glanville WA, Barker GC, Benschop J, Buza JJ, Cleaveland S, Davis MA, French NP, Mmbaga BT, Prinsen G, Swai ES, Zadoks RN, Crump JA. Prevalence of Campylobacter and Salmonella in African food animals and meat: A systematic review and meta-analysis. Int J Food Microbiol 2020; 315:108382. [PMID: 31710971 PMCID: PMC6985902 DOI: 10.1016/j.ijfoodmicro.2019.108382] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 08/20/2019] [Accepted: 10/02/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Campylobacter and Salmonella, particularly non-typhoidal Salmonella, are important bacterial enteric pathogens of humans which are often carried asymptomatically in animal reservoirs. Bacterial foodborne infections, including those derived from meat, are associated with illness and death globally but the burden is disproportionately high in Africa. Commercial meat production is increasing and intensifying in many African countries, creating opportunities and threats for food safety. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, we searched six databases for English language studies published through June 2016, that reported Campylobacter or Salmonella carriage or infection prevalence in food animals and contamination prevalence in food animal products from African countries. A random effects meta-analysis and multivariable logistic regression were used to estimate the species-specific prevalence of Salmonella and Campylobacter and assess relationships between sample type and region and the detection or isolation of either pathogen. RESULTS Seventy-three studies reporting Campylobacter and 187 studies reporting Salmonella across 27 African countries were represented. Adjusted prevalence calculations estimate Campylobacter detection in 37.7% (95% CI 31.6-44.3) of 11,828 poultry samples; 24.6% (95% CI 18.0-32.7) of 1975 pig samples; 17.8% (95% CI 12.6-24.5) of 2907 goat samples; 12.6% (95% CI 8.4-18.5) of 2382 sheep samples; and 12.3% (95% CI 9.5-15.8) of 6545 cattle samples. Salmonella were detected in 13.9% (95% CI 11.7-16.4) of 25,430 poultry samples; 13.1% (95% CI 9.3-18.3) of 5467 pig samples; 9.3% (95% CI 7.2-12.1) of 2988 camel samples; 5.3% (95% CI 4.0-6.8) of 72,292 cattle samples; 4.8% (95% CI 3.6-6.3) of 11,335 sheep samples; and 3.4% (95% CI 2.2-5.2) of 4904 goat samples. 'External' samples (e.g. hide, feathers) were significantly more likely to be contaminated by both pathogens than 'gut' (e.g. faeces, cloaca) while meat and organs were significantly less likely to be contaminated than gut samples. CONCLUSIONS This study demonstrated widespread prevalence of Campylobacter species and Salmonella serovars in African food animals and meat, particularly in samples of poultry and pig origin. Source attribution studies could help ascertain which food animals are contributing to human campylobacteriosis and salmonellosis and direct potential food safety interventions.
Collapse
Affiliation(s)
- Kate M Thomas
- Centre for International Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; Kilimanjaro Clinical Research Institute, Good Samaritan Foundation, Moshi, United Republic of Tanzania.
| | - William A de Glanville
- Institute of Biodiversity Animal Health and Comparative Medicine, College of Medical Veterinary & Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | | | | | - Joram J Buza
- School of Life Sciences and Bio-Engineering, Nelson Mandela African Institution of Science and Technology, Arusha, United Republic of Tanzania
| | - Sarah Cleaveland
- Institute of Biodiversity Animal Health and Comparative Medicine, College of Medical Veterinary & Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Margaret A Davis
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, United States of America
| | - Nigel P French
- mEpiLab, Massey University, Palmerston North, New Zealand; New Zealand Food Safety Science and Research Centre, New Zealand
| | - Blandina T Mmbaga
- Kilimanjaro Clinical Research Institute, Good Samaritan Foundation, Moshi, United Republic of Tanzania
| | - Gerard Prinsen
- School of People, Environment and Planning, Massey University, Palmerston North, New Zealand
| | - Emmanuel S Swai
- State Department of Veterinary Services, Ministry of Livestock and Fisheries, Dodoma, United Republic of Tanzania
| | - Ruth N Zadoks
- Institute of Biodiversity Animal Health and Comparative Medicine, College of Medical Veterinary & Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - John A Crump
- Centre for International Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| |
Collapse
|
|
41
|
Klonowski A, Schwarting A. [Infection-triggered arthralgia and arthritis]. MMW Fortschr Med 2020; 162:39-42. [PMID: 32016764 DOI: 10.1007/s15006-020-0104-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Anna Klonowski
- Schwerpunkt Rheumatologie und klinische Immunologie, Universitätsmedizin Mainz, Langenbeckstr. 1, D-55131, Mainz, Deutschland
| | - Andreas Schwarting
- Schwerpunkt Rheumatologie und klinische Immunologie, Universitätsmedizin Mainz, Langenbeckstr. 1, D-55131, Mainz, Deutschland.
- ACURA Rheumakliniken Rheinland-Pfalz, Bad Kreuznach, Deutschland.
| |
Collapse
|
|
42
|
Garland SG, Falk NP. Rheumatoid Arthritis and Related Disorders. Fam Med 2020. [DOI: 10.1007/978-1-4939-0779-3_120-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
|
43
|
Abstract
PURPOSE OF REVIEW Recent studies regarding the frequency of Chlamydia-induced reactive arthritis (ReA) are reviewed, with a focus on the question of whether the entity is in fact disappearing or whether it is simply being underdiagnosed/underreported. Epidemiological reports indicate diversity in the frequency of Chlamydia-associated ReA in various parts of the world, with evidence of declining incidence in some regions. RECENT FINDINGS The hypothesis that early effective treatment with antibiotics prevents the manifestation of Chlamydia-associated ReA requires further investigation. For clinicians, it is important to remember that ReA secondary to Lymphogranuloma venereum (LGV) serovars L1-L3 of C. trachomatis is probably underestimated due to a limited awareness of this condition, the re-emergence in Western countries of LGV overall, and the present increasingly rare classical inguinal presentation.
Collapse
|
|
44
|
Kim HY, Kim J, Jeong HJ, Kim HM. Potential anti-inflammatory effect of Madi-Ryuk and its active ingredient tannic acid on allergic rhinitis. Mol Immunol 2019; 114:362-368. [PMID: 31450181 DOI: 10.1016/j.molimm.2019.08.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/14/2019] [Accepted: 08/18/2019] [Indexed: 02/06/2023]
Abstract
Madi-Ryuk (MDR) is a traditional Korean medicine and it has been widely used in Korea to treat arthritis and we previously reported the anti-allergic inflammatory effect of MDR in vitro model. However, therapeutic evidence of MDR on in vivo model of allergic inflammatory reaction has not yet been demonstrated. The research purpose was to investigate the efficacy of MDR and its active ingredient tannic acid (TA) in ovalbumin (OVA)-induced AR mice model. OVA-challenged AR mice orally medicated MDR or its active ingredient TA daily for ten days. In mice having a AR, MDR and TA prominently diminished number of rubs and levels of histamine, IgE, thymic stromal lymphopoietin, interleukin (IL)-1β, IL-4, IL-5, IL-13, IL-33, and tumor necrosis factor-α. In addition, protein expression levels and activities of caspase-1 were declined by oral medication of MDR and TA. Decline in levels of macrophage inflammatory protein-2 and intercellular adhesion molecules-1 and reduction in penetrations of inflammatory cells into inflamed tissue were also noted in MDR and TA groups. Taken together, identification of MDR effect in preclinical models suggests that MDR may be a therapeutic drug for the treatment and prevention of AR.
Collapse
Affiliation(s)
- Hee-Yun Kim
- Department of Pharmacology, College of Korean Medicine, Kyung Hee University, Seoul, 130-701, Republic of Korea
| | - Jihyeon Kim
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Hyun-Ja Jeong
- Division of Food and Pharmaceutical Engineering, Hoseo University, 20, Hoseo-ro 79 beon-gil, Baebang-eup, Asan, Chungcheongnam-do 31499, Republic of Korea.
| | - Hyung-Min Kim
- Department of Pharmacology, College of Korean Medicine, Kyung Hee University, Seoul, 130-701, Republic of Korea; Department of Science in Korean Medicine, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea.
| |
Collapse
|
|
45
|
Bacterial Amyloids: The Link between Bacterial Infections and Autoimmunity. Trends Microbiol 2019; 27:954-963. [PMID: 31422877 DOI: 10.1016/j.tim.2019.07.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/19/2019] [Accepted: 07/03/2019] [Indexed: 12/13/2022]
Abstract
Molecular mimicry is a common mechanism used by many bacteria to evade immune responses. In recent years, it has become evident that bacteria also decorate the extracellular matrix (ECM) of their biofilms with molecules that resemble those of the host. These molecules include amyloids and other proteins, polysaccharides, and extracellular DNA. Bacterial amyloids, like curli, and extracellular DNA are found in the biofilms of many species. Recent work demonstrated that curli and DNA form unique molecular structures that are recognized by the immune system, causing activation of autoimmune pathways. Although a variety of mechanisms have been suggested as the means by which infections initiate and/or exacerbate autoimmune diseases, the mechanism remains unknown. In this article, we discuss recent work on biofilms that highlight the role of amyloids as a carrier for DNA and potentiator of autoimmune responses, and we propose a novel link between bacterial infections and autoimmune diseases.
Collapse
|
|
46
|
Chlamydiaceae: Diseases in Primary Hosts and Zoonosis. Microorganisms 2019; 7:microorganisms7050146. [PMID: 31137741 PMCID: PMC6560403 DOI: 10.3390/microorganisms7050146] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 05/19/2019] [Accepted: 05/20/2019] [Indexed: 12/23/2022] Open
Abstract
Bacteria of the Chlamydiaceae family are a type of Gram-negative microorganism typified by their obligate intracellular lifestyle. The majority of the members in the Chlamydiaceae family are known pathogenic organisms that primarily infect the host mucosal surfaces in both humans and animals. For instance, Chlamydia trachomatis is a well-known etiological agent for ocular and genital sexually transmitted diseases, while C. pneumoniae has been implicated in community-acquired pneumonia in humans. Other chlamydial species such as C. abortus, C. caviae, C. felis, C. muridarum, C. pecorum, and C. psittaci are important pathogens that are associated with high morbidities in animals. Importantly, some of these animal pathogens have been recognized as zoonotic agents that pose a significant infectious threat to human health through cross-over transmission. The current review provides a succinct recapitulation of the characteristics as well as transmission for the previously established members of the Chlamydiaceae family and a number of other recently described chlamydial organisms.
Collapse
|
|
47
|
Rheumatoid arthritis (RA) and cardiovascular disease. Autoimmun Rev 2019; 18:679-690. [PMID: 31059840 DOI: 10.1016/j.autrev.2019.05.005] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 01/27/2019] [Indexed: 12/13/2022]
Abstract
Patients with rheumatoid arthritis (RA) suffer cardiovascular events 1.5-2 fold than the general population, and cardiovascular (CV) events are leading cause of death in patients with RA. It is known that patients with RA have endothelial dysfunction, related with impaired function of endothelial progenitor cells (EPCs). The mechanistic pathways leading to endothelial function are complicated, but understanding these mechanisms may open new frontiers of management and therapies to patients suffering from atherosclerosis. Inflammation is a key factor in atherosclerosis, including endothelial function, plaque stabilization and post infarct remodeling; thus, inhibition of TNF-α may affect the inflammatory burden and plaque vulnerability leading to less cardiovascular events and myocardial infarctions. An aggressive management of inflammation may lead to a significant improvement in the clinical cardiovascular outcome of patients with RA. The clinical evidence that showed a reduced risk of CV events following treatment with anti-inflammatory agents may suggest a new approach to treat atherosclerosis, i.e., inhibition of inflammation using biological medications that were primarily aimed to treat the high scale inflammation of RA and other autoimmune-inflammatory diseases, but may be useful also to prevent progression of atherosclerosis.
Collapse
|
|
48
|
What's causing this patient's hip pain and eye irritation? JAAPA 2019; 30:55-56. [PMID: 28538433 DOI: 10.1097/01.jaa.0000516359.42244.c7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
|
49
|
Handattu K, Bhat Yellanthoor R, Konda KC, Kini S. Acute severe monarthritis: a rare manifestation of scrub typhus. BMJ Case Rep 2018; 11:11/1/bcr-2018-227002. [PMID: 30567173 DOI: 10.1136/bcr-2018-227002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Scrub typhus caused by Orientia tsutsugamushi is an important cause for fever of unknown origin in endemic areas including India. The vasculitis associated with the disease leads to a variety of clinical manifestations. However, the joint involvement is quite rare and not reported in children. We present severe arthritis of hip joint associated with scrub typhus causing a diagnostic and management challenges in a 4-year-old girl.
Collapse
Affiliation(s)
- Koushik Handattu
- Paediatrics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | | | | | - Sandesh Kini
- Paediatrics, Kasturba Medical College, Manipal, Karnataka, India
| |
Collapse
|
|
50
|
Marchetti C, Swartzwelter B, Koenders MI, Azam T, Tengesdal IW, Powers N, de Graaf DM, Dinarello CA, Joosten LAB. NLRP3 inflammasome inhibitor OLT1177 suppresses joint inflammation in murine models of acute arthritis. Arthritis Res Ther 2018; 20:169. [PMID: 30075804 PMCID: PMC6091035 DOI: 10.1186/s13075-018-1664-2] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 07/09/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Activation of the NLRP3 inflammasome in gout amplifies the inflammatory response and mediates further damage. In the current study, we assessed the therapeutic effect of OLT1177, an orally active NLRP3 inflammasome inhibitor that is safe in humans, in murine acute arthritis models. METHODS Zymosan or monosodium urate (MSU) crystals were injected intra-articularly (i.a.) into mouse knee joints to induce reactive or gouty arthritis. Joint swelling, articular cell infiltration, and synovial cytokines were evaluated 25 hours and 4 hours following zymosan or MSU challenge, respectively. OLT1177 was administrated intraperitoneally by oral gavage or in the food by an OLT1177-enriched diet. RESULTS OLT1177 reduced zymosan-induced joint swelling (p < 0.001), cell influx (p < 0.01), and synovial levels of interleukin (IL)-1β, IL-6, and chemokine (C-X-C motif) ligand 1 (CXCL1) (p < 0.05), respectively, when compared with vehicle-treated mice. Plasma OLT1177 levels correlated (p < 0.001) dose-dependently with reduction in joint inflammation. Treatment of mice with OLT1177 limited MSU crystal articular inflammation (p > 0.0001), which was associated with decreased synovial IL-1β, IL-6, myeloperoxidase, and CXCL1 levels (p < 0.01) compared with vehicle-treated mice. When administrated orally 1 hour after MSU challenge, OLT1177 reduced joint inflammation, processing of IL-1β, and synovial phosphorylated c-Jun N-terminal kinase compared with the vehicle group. Mice were fed an OLT1177-enriched diet for 3 weeks and then challenged i.a. with MSU crystals. Joint swelling, synovial IL-1β, and expression of Nlrp3 and Il1b were significantly reduced in synovial tissues in mice fed an OLT1177-enriched diet when compared with the standard diet group. CONCLUSIONS Oral OLT1177 is highly effective in ameliorating reactive as well as gouty arthritis.
Collapse
Affiliation(s)
- Carlo Marchetti
- Department of Medicine, University of Colorado Denver, Aurora, CO USA
| | | | - Marije I. Koenders
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tania Azam
- Department of Medicine, University of Colorado Denver, Aurora, CO USA
| | - Isak W. Tengesdal
- Department of Medicine, University of Colorado Denver, Aurora, CO USA
- Department of Internal Medicine and Radboud Institute of Molecular Life Sciences (RIMLS), Radboud University Medical Center, Geert Grooteplein Zuid 8, 6525 GA Nijmegen, The Netherlands
| | - Nick Powers
- Department of Medicine, University of Colorado Denver, Aurora, CO USA
| | - Dennis M. de Graaf
- Department of Medicine, University of Colorado Denver, Aurora, CO USA
- Department of Internal Medicine and Radboud Institute of Molecular Life Sciences (RIMLS), Radboud University Medical Center, Geert Grooteplein Zuid 8, 6525 GA Nijmegen, The Netherlands
| | - Charles A. Dinarello
- Department of Medicine, University of Colorado Denver, Aurora, CO USA
- Department of Internal Medicine and Radboud Institute of Molecular Life Sciences (RIMLS), Radboud University Medical Center, Geert Grooteplein Zuid 8, 6525 GA Nijmegen, The Netherlands
| | - Leo A. B. Joosten
- Department of Medicine, University of Colorado Denver, Aurora, CO USA
- Department of Internal Medicine and Radboud Institute of Molecular Life Sciences (RIMLS), Radboud University Medical Center, Geert Grooteplein Zuid 8, 6525 GA Nijmegen, The Netherlands
| |
Collapse
|