Antibody response against 26 and 46 kilodalton released proteins of yersinia in yersinia triggered reactive arthritis

Usefulness of complex bacteriological and serological analysis in patients with spondyloarthritis

Spondyloarthritis (SpA) is a group of associated chronic systemic inflammatory immune-mediated rheumatic diseases affecting axial and peripheral joints and entheses. The aim of the present study was to identify what parameters are useful to determine in order to better understand the correlation between the disease activity/severity and the microbiological results/immune status against intestinal and/or urogenital pathogens. Microorganisms known to trigger SpA, including Klebsiella spp., Yersinia spp., Salmonella spp., Campylobacter spp. and Chlamydia spp., were analyzed in various specimens (stool, urine, synovial fluid and serum) collected from 27 randomly selected SpA patients and 26 healthy controls using a combined direct and indirect approach relying on conventional culture technique and nucleic acid-based assays together with serological testing by ELISA. Although Escherichia coli derived from phylogroup A prevailed in the gut microflora of the patients and controls, differences were observed regarding the representatives of the other phylogroups with a higher prevalence of E.coli members of phylogenetic group B1 in the stool specimens of patients. Antibodies against the targeted species were detected in SpA patients and controls, and the serological profiles of the former were more diverse and complex. In conclusion, the detection of anti-bacterial antibodies combined with other specific laboratory investigations should be more extensively used to monitor SpA patients in association with their symptoms and in order to determine and administer more effective therapeutics.

Infection-related arthritis

Postinfection arthritis represents a significant portion of the referrals to pediatric rheumatology centers, particularly in the United States. Many viral and common bacterial infections can be associated with arthritis, and their recognition can sometimes be difficult on a clinical basis. In patients with acute onset of arthritis, the clinician should actively seek epidemiologic, clinical, or laboratory evidence of infection. Diagnostic tests should be used rationally and results interpreted carefully. Some infections, once recognized, require antibiotic treatment, but in most cases anti-inflammatory therapy is successful in treating articular symptoms.

Analysis of the immune response to Yersinia enterocolitica serotype-O:9-released proteins by immunoblot and ELISA

The immune response towards the released Yersinia enterocolitica outer membrane proteins (Yop) was analysed by immunoblotting and ELISA using a rabbit experimental model. Rabbits orogastrically or intravenously infected with the virulent (plasmid-bearing) Y. enterocolitica O:9 W836 strain developed a significant response by (IgG) antibodies to the released proteins having molecular weights of 51 (YopH) and 41 (LcrV) kDa, respectively. However, only in animals infected via the orogastric route were specific antibodies of the IgG class found against plasmid-encoded polypeptides of 35 (YopN) and 20 (YopQ) kDa. These results suggest that the expression of Yop in vivo may be conditioned by the route of infection used. Using ELISA, a significant response by IgG-class antibodies to YopH protein was evident in the sera from rabbits both orogastrically and intravenously infected with the virulent (pYV+) Y. enterocolitica O:9 W836 strain. By contrast, no specific antibodies to this antigen were detected in sera of rabbit infected with an avirulent (plasmid-cured) derivative (pYV-) strain. Accordingly, this protein could be very useful as an antigen in ELISA for serological diagnosis of infections caused by enteropathogenic strains of Yersinia spp.

Yersinia-specific antibodies in serum and synovial fluid in patients with Yersinia triggered reactive arthritis

OBJECTIVES

To further evaluate the role of bacterial antigens in triggering inflammation in the joint in patients with reactive arthritis by studying local antibody synthesis in the joint.

METHODS

Yersinia-specific antibodies in paired serum and synovial fluid samples from 29 patients with yersinia triggered reactive arthritis were studied using an enzyme linked immunosorbent assay (ELISA), an inhibition ELISA with six monoclonal antibodies against lipopolysaccharide or released proteins of yersinia and immunoblotting. Antibodies of IgM, IgG and IgA classes, as well as antibodies of IgA subclasses and those containing secretory component were measured against the lipopolysaccharide and the sodium dodecyl sulphate extract of whole Yersinia enterocolitica O:3 bacteria.

RESULTS

It was shown that yersinia-specific antibodies, as well as antibodies against other microbial antigens (rubella, measles, Bordetella pertussis, tetanus toxoid and Candida albicans) in synovial fluid mirror those in serum by concentration, by specificity and by distribution in classes and subclasses.

CONCLUSION

These results do not suggest any strong local antibody production, but indicate that the majority of yersinia antibodies in the synovial fluid are derived from the circulation.