Studies on the Role of Chlamydia trachomatis Infection in the Pathogenesis of Reactive Arthritis/ Undifferentiated Spondyloarthropathy

Abstract

Reactive Arthritis/ undifferentiated spondyloarthropathy due to Chlamydia newlinetrachomatis is largely asymptomatic hence get unnoticed further, it causes chronic newlineinfection in major joints of male and female patients. Role of Chlamydia trachomatis in newlinethe pathogenesis in ReA/ uSpA patients was studied by estimating the frequency of newlineinfection. Intra-articular infection for either C. trachomatis MOMP/ plasmid was found in newline24.4% (11/45) ReA/ uSpA patients by either snPCR/ nPCR; plasmid and MOMP were newlinefound in 11/45 (24.4%) and 7/45 (15.5%) patients, respectively. 28.5% (6/21) ReA and newline20.8% (5/24) uSpA patients were found positive for either MOMP/ plasmid gene of C. newlinetrachomatis. The plasmid gene was also detected by PCR (conventional) in the urine of newline17.3% (6/35) uSpA patients without effusions. Cytological detection by DFA showed the newlinepresence of C. trachomatis EBs in the SF of 31.1% (14/45) ReA/ uSpA patients; while in newlinethe urine of uSpA patients without effusions, 13.3% (6/45) were C. trachomatis-positive. newlineAlthough anti-chlamydial antibodies (IgM, IgG, IgA) were detected in SF/ serum of ReA/ newlineuSpA patients, however, only anti-C. trachomatis IgA antibodies showed diagnostic newlineimportance (SF- 31.1%; 14/45 and serum 15.5%; 7/45). It was concluded that nPCR newlineshould be the method of choice for diagnosing intra-articular C. trachomatis DNA in SF newlineof chronic ReA/ uSpA patients with effusion. DFA for an initial rapid detection of an newlineacute episode of infection followed by the more confirmatory molecular diagnostic newlinemethod. Overall, the SF was found to be a more conclusive clinical specimen in both newlineacute and chronically C. trachomatis-infected ReA/ uSpA patients with effusion in terms newlineof molecular diagnosis by nPCR, C. trachomatis MOMP antigen detection and antichlamydial antibody response.