Causality of Chlamydiae in Arthritis and Spondyloarthritis: a Plea for Increased Translational Research

Overview

Journal Curr Rheumatol Rep

Publisher Current Science

Specialty Rheumatology

Date 2016 Jan 16

PMID 26769308

Citations 13

Authors

Henning Zeidler

Alan P Hudson

Affiliations

Soon will be listed here.

Abstract

Current molecular genetic understanding of the metabolically active persistent infection state of Chlamydia trachomatis and Chlamydia pneumoniae in the synovium in patients with arthritis and spondyloarthritis favors a causal relationship. Here, we examine how adequately the accepted criteria for that etiologic relationship are fulfilled, emphasizing the situation in which these microorganisms cannot be cultivated by standard or other means. We suggest that this unusual situation of causality by chlamydiae in rheumatic disease requires establishment of a consensus regarding microorganism-specific terminology as well as the development of new diagnostic and classification criteria. Recent studies demonstrate the value of molecular testing for diagnosis of reactive arthritis, undifferentiated spondyloarthritis, and undifferentiated arthritis caused by C. trachomatis and C. pneumoniae in clinical practice. Data regarding combination antibiotic therapy is consistent with the causative role of chlamydiae for these diseases. Observations of multiple intra-articular coinfections require more research to understand the implications and to respond to them.

Citing Articles

[Reactive arthritis].

Rihl M, Kuipers J Z Rheumatol. 2024; .

PMID: 39621046 DOI: 10.1007/s00393-024-01594-9.

Oxidative Stress and Inflammation in SARS-CoV-2- and -Associated Cardiovascular Diseases.

Filardo S, Di Pietro M, Diaco F, Romano S, Sessa R Biomedicines. 2021; 9(7).

PMID: 34202515 PMC: 8301438. DOI: 10.3390/biomedicines9070723.

Super-Resolution Fluorescence Microscopy Reveals Clustering Behaviour of Major Outer Membrane Protein.

Danson A, McStea A, Wang L, Pollitt A, Martin-Fernandez M, Moraes I Biology (Basel). 2020; 9(10).

PMID: 33092039 PMC: 7589890. DOI: 10.3390/biology9100344.

Associated Reactive Arthritis: A Urinary PCR Based Study.

Sharma M, Sharma S, Sharma A, Sharma K Indian Dermatol Online J. 2020; 11(1):21-24.

PMID: 32055503 PMC: 7001391. DOI: 10.4103/idoj.IDOJ_410_19.

Chronic Inflammatory Diseases at Secondary Sites Ensuing Urogenital or Pulmonary Infections.

Cheok Y, Lee C, Cheong H, Looi C, Wong W Microorganisms. 2020; 8(1).

PMID: 31963395 PMC: 7022716. DOI: 10.3390/microorganisms8010127.

References

Klos A, Thalmann J, Peters J, Gerard H, Hudson A . The transcript profile of persistent Chlamydophila (Chlamydia) pneumoniae in vitro depends on the means by which persistence is induced. FEMS Microbiol Lett. 2008; 291(1):120-6. DOI: 10.1111/j.1574-6968.2008.01446.x. View

Hannu T . Reactive arthritis. Best Pract Res Clin Rheumatol. 2011; 25(3):347-57. DOI: 10.1016/j.berh.2011.01.018. View

Zeidler H . The need to better classify and diagnose early and very early rheumatoid arthritis. J Rheumatol. 2011; 39(2):212-7. DOI: 10.3899/jrheum.110967. View

Harrer T, Bauerle M, Bergmann S, Eismann K, Harrer E . Inhibition of HIV-1-specific T-cells and increase of viral load during immunosuppressive treatment in an HIV-1 infected patient with Chlamydia trachomatis induced arthritis. J Clin Virol. 2005; 34(3):224-30. DOI: 10.1016/j.jcv.2005.07.006. View

Gerard H, Stanich J, Whittum-Hudson J, Schumacher H, Carter J, Hudson A . Patients with Chlamydia-associated arthritis have ocular (trachoma), not genital, serovars of C. trachomatis in synovial tissue. Microb Pathog. 2009; 48(2):62-8. PMC: 2815210. DOI: 10.1016/j.micpath.2009.11.004. View

Bebear C, De Barbeyrac B . Genital Chlamydia trachomatis infections. Clin Microbiol Infect. 2009; 15(1):4-10. DOI: 10.1111/j.1469-0691.2008.02647.x. View

Zeidler H, Calin A, Amor B . A historical perspective of the spondyloarthritis. Curr Opin Rheumatol. 2011; 23(4):327-33. DOI: 10.1097/BOR.0b013e3283470ecd. View

Carter J, Valeriano J, Vasey F . Doxycycline versus doxycycline and rifampin in undifferentiated spondyloarthropathy, with special reference to chlamydia-induced arthritis. A prospective, randomized 9-month comparison. J Rheumatol. 2004; 31(10):1973-80. View

Schumacher Jr H, Gerard H, Arayssi T, Pando J, Branigan P, Saaibi D . Lower prevalence of Chlamydia pneumoniae DNA compared with Chlamydia trachomatis DNA in synovial tissue of arthritis patients. Arthritis Rheum. 1999; 42(9):1889-93. DOI: 10.1002/1529-0131(199909)42:9<1889::AID-ANR13>3.0.CO;2-W. View

10.

Zeidler H . How can misclassification be prevented when using the 2010 American College of Rheumatology/European League Against Rheumatism rheumatoid arthritis classification criteria? Comment on the article by van der Linden et al. Arthritis Rheum. 2011; 63(8):2544-6. DOI: 10.1002/art.30442. View

11.

Gerard H, Whittum-Hudson J, Carter J, Hudson A . The pathogenic role of Chlamydia in spondyloarthritis. Curr Opin Rheumatol. 2010; 22(4):363-7. DOI: 10.1097/BOR.0b013e32833952cb. View

12.

Carter J, Gerard H, Whittum-Hudson J, Hudson A . The molecular basis for disease phenotype in chronic Chlamydia-induced arthritis. Int J Clin Rheumtol. 2013; 7(6):627-640. PMC: 3579635. DOI: 10.2217/ijr.12.65. View

13.

Ozgul A, Dede I, Taskaynatan M, Aydogan H, Kalyon T . Clinical presentations of chlamydial and non-chlamydial reactive arthritis. Rheumatol Int. 2006; 26(10):879-85. DOI: 10.1007/s00296-005-0094-z. View

14.

Gerard H, Wang Z, Rudy D, Rao J, Zeidler H, Schumacher H . Expression of Chlamydia trachomatis genes encoding products required for DNA synthesis and cell division during active versus persistent infection. Mol Microbiol. 2001; 41(3):731-41. DOI: 10.1046/j.1365-2958.2001.02550.x. View

15.

Carter J, Espinoza L, Inman R, Sneed K, Ricca L, Vasey F . Combination antibiotics as a treatment for chronic Chlamydia-induced reactive arthritis: a double-blind, placebo-controlled, prospective trial. Arthritis Rheum. 2010; 62(5):1298-307. PMC: 2907099. DOI: 10.1002/art.27394. View

16.

Sieper J, Rudwaleit M, Braun J, van der Heijde D . Diagnosing reactive arthritis: role of clinical setting in the value of serologic and microbiologic assays. Arthritis Rheum. 2002; 46(2):319-27. DOI: 10.1002/art.504. View

17.

Freise J, Bernau I, Meier S, Zeidler H, Kuipers J . Detection of Chlamydia trachomatis-DNA in synovial fluid: evaluation of the sensitivity of different DNA extraction methods and amplification systems. Arthritis Res Ther. 2009; 11(6):R175. PMC: 3003517. DOI: 10.1186/ar2864. View

18.

Dreses-Werringloer U, Padubrin I, Zeidler H, Kohler L . Effects of azithromycin and rifampin on Chlamydia trachomatis infection in vitro. Antimicrob Agents Chemother. 2001; 45(11):3001-8. PMC: 90774. DOI: 10.1128/AAC.45.11.3001-3008.2001. View

19.

Batut J, Andersson S, OCallaghan D . The evolution of chronic infection strategies in the alpha-proteobacteria. Nat Rev Microbiol. 2004; 2(12):933-45. DOI: 10.1038/nrmicro1044. View

20.

Bas S, Vischer T . Humoral immunity in Chlamydia trachomatis arthritis. Rev Rhum Engl Ed. 1999; 66(1 Suppl):34S-35S; discussion 36S. View