Causality of Chlamydiae in Arthritis and Spondyloarthritis: a Plea for Increased Translational Research
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  • 作者：Henning Zeidler ; Alan P. Hudson
  • 关键词：Chlamydia arthritis ; Chlamydia spondyloarthritis ; Chlamydia trachomatis ; Chlamydia pneumoniae ; Reactive arthritis ; Spondyloarthritis ; Slow bacterial infection ; Coinfection ; Antibiotic combination therapy
  • 刊名：Current Rheumatology Reports
  • 出版年：2016
  • 出版时间：January 2016
  • 年：2016
  • 卷：18
  • 期：2
  • 全文大小：984 KB
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  • 作者单位：Henning Zeidler (1)
    Alan P. Hudson (2)

    1. Division of Clinical Immunology and Rheumatology, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
    2. Department of Immunology and Microbiology, Wayne State University School of Medicine, Detroit, MI, USA
  • 刊物主题：Rheumatology;
  • 出版者：Springer US
  • ISSN：1534-6307
    • 文摘
    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. Keywords Chlamydia arthritis Chlamydia spondyloarthritis Chlamydia trachomatis Chlamydia pneumoniae Reactive arthritis Spondyloarthritis Slow bacterial infection Coinfection Antibiotic combination therapy
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