Investigation of infectious agents associated with arthritis by reverse transcription PCR of bacterial rRNA

        在反应性和感染后关节炎中，关节通常是无菌的，但存在细菌抗原和核酸，已被报道过。调查在这些条件下是否有机体影响关节，我们进行反转录PCR，使用通用引物扩增存在于滑液中的任何细菌16S rRNA序列。在大多数情况下，可以检测到细菌序列，甚至于在用DNA酶处理关节滑液后，暗示细菌RNA的存在以及因此的转录活性细菌。分析大量的序列揭示，如在类风湿性关节炎中报道的，大多数衍生自肠和皮肤共生。在每一个已知已触发关节炎的病例中有机体没有被发现，但是通过种属特异性引物扩增后在某些病例中可以发现。这是假结核耶尔森菌和沙眼衣原体的情况。然而，在被认为与空肠弯曲杆菌感染有关的关节炎中，获得的序列不是来自空肠弯曲杆菌或大肠杆菌，而来自其他弯曲杆菌属，后者并不确定是否与反应性关节炎相关，且其可能作为共生体存在于肠道中。我们得出结论，虽然在受影响的关节中可以检测到来自于反应性关节炎相关生物的rRNA，但是来自许多其他的细菌RNA细菌也存在，如先前在研究中所指出的其他形式的炎性关节病。

        In reactive and postinfectious arthritis the joints are generallysterile but the presence of bacterial antigens and nucleic acidshas been reported. To investigate whether organisms traffic toaffected joints in these conditions, we performed reversetranscription PCR using universal primers to amplify anybacterial 16S rRNA sequences present in synovial fluid.Bacterial sequences were detected in most cases, even aftertreatment of the synovial fluid with DNase, implying thepresence of bacterial RNA and therefore of transcriptionallyactive bacteria. Analysis of a large number of sequencesrevealed that, as reported in rheumatoid arthritis, most werederived from gut and skin commensals. Organisms known tohave triggered arthritisin each case were not found by sequencing the products obtained using universal primers, butcould in some cases be shown to be present by amplifying withspecies specific primers. This was the case for Yersiniapseudotuberculosis and Chlamydia trachomatis. However, inarthritis thought to be related to Campylobacter infection thesequences obtained were not from Campylobacter jejuni orC. coli, but from other Campylobacter spp. that are not knownto be associated with reactive arthritis and are probablypresent as commensals in the gut. We conclude that althoughrRNA from reactive arthritis associated organisms can bedetected in affected joints, bacterial RNA from many otherbacteria is also present, as was previously noted in studies ofother forms of inflammatory arthropathy.

        编译者：赵倩倩，西京医院临床免疫科