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Extended report
Detection of multiple viral DNA species in synovial tissue and fluid of patients with early arthritis
  1. Hans-Detlev Stahla,
  2. Bernd Hubnerb,
  3. Bernd Seidla,
  4. Uwe G Liebertc,
  5. Ineke M van der Heijdend,
  6. Bert Wilbrinke,
  7. Maarten C Kraanf,
  8. Frank Emmricha,
  9. Paul P Takf
  1. aInstitute of Clinical Immunology and Transfusion Medicine, University of Leipzig, Leipzig, Germany, bInstitute of Anatomy, University of Leipzig, cInstitute of Virology, University of Leipzig, dDepartment of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands, eResearch Laboratory for Infectious Diseases, National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands, fDivision of Clinical Immunology and Rheumatology, Department of Internal Medicine, Academic Medical Centre, Meibergdreef 9, PO Box 22660, 1100 DD Amsterdam, The Netherlands
  1. Professor Tak Email: P.P.Tak{at}amc.uva.nL

Abstract

OBJECTIVE Viruses have a role in the pathogenesis of various forms of arthritis. This study aimed at determining whether viral DNA can be detected in joint samples in the early stages of idiopathic arthritides.

METHODS Synovial fluid (SF) and synovial tissue (ST) samples were obtained from 73 patients, with undifferentiated arthritis (n=22), rheumatoid arthritis (n=13), spondyloarthropathy (n=17), crystal arthropathy (n=8), osteoarthritis (n=7), septic arthritis (n=5), and trauma (n=1). The presence of viral DNA was investigated by polymerase chain reaction analysis.

RESULTS Cytomegalovirus was present in 25 patients, parvovirus B19 in 15 patients, Epstein-Barr virus in 12 patients, and herpes simplex virus in 16 patients (in ST, SF, or both), respectively. The joint samples were negative for viral DNA from adenovirus and varicella-zoster virus. In ST, eight patients were double positive for parvovirus B19 and another viral DNA, with herpes simplex virus being the most prevalent. Seven patients were double positive for other viruses (cytomegalovirus, herpes simplex virus, Epstein-Barr virus). In SF, four patients were double or triple positive for viral DNA. Paired samples were available in 56 patients. In these, viral DNA was detected in 37 patients in ST, as compared with 19 in SF.

CONCLUSION These data show that one or more viruses can be detected in the synovial specimens of patients with early arthritis, irrespective of the clinical diagnosis. This observation might be explained by migration of inflammatory cells harbouring viral DNA into the inflamed joints.

  • virus
  • DNA
  • polymerase chain reaction
  • early arthritis
  • undifferentiated arthritis
  • rheumatoid arthritis
  • synovial tissue
  • synovial fluid

https://doi.org/10.1136/ard.59.5.342

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