Hypothesis
How can a causal role for small bacteria in chronic inflammatory arthritides be established or refuted?
D Taylor-Robinsona, A Keatba Department of
Genitourinary Medicine, Imperial College School of Medicine, St Mary's
Campus, London W2 1NY, UK, b Department of Rheumatology, Northwick Park and
St Mark's Hospitals, Harrow, Middlesex HA1 3UJ, UK
Correspondence to: Dr Keat
Accepted for publication 29 August 2000
| The first 150 words of the full text of this article appear below. |
 |
Introduction |
|---|
The concept of septic arthritis in which bacteria replicate in joint tissue and cause inflammation, joint destruction, and sometimes death is well established. Equally, the idea that some forms of aseptic inflammatory arthritis, such as rheumatoid arthritis, may well be provoked or sustained by the direct or indirect effects of microbial infection is familiar and attractive, though the notion is underpinned more by logic than by data. Between these extremes, reactive arthritis appears to offer a new understanding of microbial pathogenesis as joints, conventionally aseptic, have been found to contain small numbers of bacteria. These bacteria, principally chlamydiae and mycoplasmas, may well provoke and maintain the arthritis. Much evidence has accumulated that they have proinflammatory components, induce immune responses, and could interact with HLA-B27 in a manner consistent with current theories of disease pathogenesis.
The issue of searching for bacteria in joint tissue, however, has
become complex. When conventional cultures
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
-
Hamdulay, S S, Glynne, S J, Keat, A
(2006). When is arthritis reactive?. Postgrad. Med. J.
82: 446-453
[Abstract] [Full Text] -
Gilroy, C. B., Keat, A., Taylor-Robinson, D.
(2001). The prevalence of Mycoplasma fermentans in patients with inflammatory arthritides. Rheumatology (Oxford)
40: 1355-1358
[Abstract] [Full Text] -
(2001). Robin Goodfellow. Rheumatology (Oxford)
40: 718-718
[Full Text]
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
-
Degenerative joint disease
-
Musculoskeletal syndromes
-
Immunology (including allergy)
-
Inflammation
-
Connective tissue disease
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
