Intestinal permeability in patients with yersinia triggered reactive arthritis

Article Abstract:

Reactive arthritis involves an inflammation of the joints and appears following an infection elsewhere in the body. Examples of bacteria that cause reactive arthritis include Yersinia, Chlamydia, Shigella, Campylobacter and Salmonella. A variety of different intestinal disorders have been associated with reactive arthritis. Gut (intestinal) abnormalities, such as lesions and ulcers, have been identified in patients with reactive arthritis. Under normal conditions, the membranes lining the gut provide a barrier that prevents bacteria and other substances in the gut from leaking out into the bloodstream and surrounding tissues. A previous study showed that four patients with Yersinia infection had alterations in their gut membranes that made the membranes more porous or leaky (permeable), thereby allowing substances to pass through and get into the blood. The membranes returned to normal two months after the infection was gone. This suggests that alterations in the membranes lining the gut, caused by infection, may play a role in the development of joint inflammation. To test this hypothesis, 16 patients with Yersinia infection (eight with reactive arthritis and eight without) and 18 patients without Yersinia infection were examined to determine whether their gut membranes were normal. This was done by giving the patients a liquid drink that contained small beads (made of polyethylene glycol) of different sizes, and determining the size of the beads that came out in the urine. The larger the size of the bead in the urine, the more porous, or leaky, is the gut membrane. The gut membranes were more leaky in patients who had Yersinia infection than in those who did not. Of the patients who had Yersinia infection, there was no difference between the gut membranes of those who had reactive arthritis and those who did not. It is concluded that infection with Yersinia can alter the membranes lining the gut and may contribute to the development of joint symptoms in persons who have a predisposition toward disease of the joints. (Consumer Summary produced by Reliance Medical Information, Inc.)

Development and progression, Arthritis, Infectious, Inflammatory bowel diseases, Yersinia enterocolitica infections, Intestinal mucosa

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Immunoblot analysis of IgM, IgG, and IgA responses to plasmid encoded released proteins of Yersinia enterocolitica in patients with or without yersina triggered reactive arthritis

Article Abstract:

The bacteria Yersinia enterocolitica causes infections of the small intestine, and may also produce reactive arthritis, or inflammation of the joints. Yersinia may contain plasmids (genetic structures) that enhance the ability of the bacteria to cause infection. Proteins coded by plasmids cause the patient to produce antibodies, which are specialized proteins that specifically bind with and inactivate foreign particles (antigens). Yersinia-infected patients, who develop reactive arthritis, differ from infected patients without reactive arthritis their ability to produce immunoglobulin (Ig) (a type of antibody) which acts against plasmid-related proteins. The levels of various types of Ig, including IgM, IgG, and IgA, were measured in patients with Y. enterocolitica infection. Antibodies of all three Ig types were produced against specific plasmid-related proteins. Within two months after the onset of yersinia infection, 18 of 19 patients who developed reactive arthritis had IgA antibodies against one of the plasmid-coded proteins. IgA antibodies were detected in only 8 of 17 patients with yersinia infection who did not have reactive arthritis. Similar immune responses were observed 8 to 12 months after the onset of infection. Thus, IgA produced against plasmid-related proteins is more prevalent in yersinia-infected patients with reactive arthritis than in infected patients without the joint disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Genetic aspects, Plasmids, Immunoglobulins

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Yersinia antigens in synovial-fluid cells from patients with reactive arthritis

Article Abstract:

Reactive arthritis is characterized by joint pain and swelling and is believed to be caused by an infection originating in another part of the body. To determine whether yersinia, a bacteria affecting the gastrointestinal tract and joints, can be isolated in the synovial fluid (fluid within the joint spaces) of infected people, 15 patients with reactive arthritis following a yersinia infection were examined. Ten of these patients had positive yersinia cultures (yersinia antigen was found, indicating presence of the bacteria) from synovial fluid, compared to the control samples (people without arthritis and history of yersinia infection) which were all negative. It is concluded that, in patients with reactive arthritis after yersinia infection, yersinia antigen can be identified in synovial fluid taken from the affected joints. It is unclear why the joints respond by developing arthritis after the infection.

Analysis, Medical examination, Synovial fluid, Antigens

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