Infectious background of patients with a history of acute anterior uveitis

• Published in: Annals of the rheumatic diseases 2002-11, Vol.61 (11), p.1012-1016
• Main Authors: Huhtinen, M, Laasila, K, Granfors, K, Puolakkainen, M, Seppälä, I, Laasonen, L, Repo, H, Karma, A, Leirisalo-Repo, M
• Format: Article
• Language: English
• Subjects: AAU; acute anterior uveitis; Acute Disease; Adult; Aged; ankylosing spondylitis; Antibodies, Bacterial - blood; Antigens; Antigens, Bacterial - blood; bacterial antigens and antibodies; Bacterial infections; Bacterial Infections - blood; Bacterial Infections - immunology; Biological and medical sciences; Blood; Case-Control Studies; chlamydial DNA; Deoxyribonucleic acid; Development and progression; Diseases of the osteoarticular system; DNA; EIA; ELISA; enzyme immunoassay; enzyme linked immunosorbent assay; Escherichia coli infections; Extended Report; Female; Follow-Up Studies; Gangrene; Helicobacter infections; HLA-B27 Antigen - analysis; Humans; Immunoglobulins; Infections; Inflammatory joint diseases; Klebsiella; Laboratories; Male; Medical sciences; microimmunofluorescence; Middle Aged; MIF; Pathogens; PBMC; PCR; peripheral blood mononuclear cells; Physiological aspects; polymerase chain reaction; ReA; reactive arthritis; Recurrence; Salmonellosis; Signal transduction; SpA; spondyloarthropathy; Studies; Tumor necrosis factor-TNF; Uveitis; Uveitis, Anterior - immunology; Uveitis, Anterior - microbiology
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.61.11.1012

Objective: To study the infectious backround of patients with a history of acute anterior uveitis (AAU) and healthy control subjects. Methods: Sixty four patients with previous AAU and 64 sex and age matched controls were studied. Serum antibodies to Salmonellae, Yersiniae, Klebsiella pneumoniae, Escherichia coli, Proteus mirabilis, Campylobacter jejuni, and Borrelia burgdorferi were measured using enzyme linked immunosorbent assay (ELISA), and antibodies to Chlamydia trachomatis and Chlamydia pneumoniae by microimmunofluorescence test. Peripheral blood mononuclear cells (PBMCs), separated by density gradient centrifugation, were studied for Salmonella and Yersinia antigens by means of an immunofluorescence test, and for C pneumoniae DNA with a polymerase chain reaction (PCR). Results: Neither prevalence nor levels of single microbial antibodies studied differed between the patients and control subjects, or between subgroups of patients created on the basis of clinical characteristics. In logistic regression analysis, the high number of recurrences (>10) of AAU was independently related to the presence of single or multiple bacterial antibodies (p=0.04). None of the PBMC samples of the patients were positive for Yersinia or Salmonella antigens. C pneumoniae PCR was positive in a patient who was negative for C pneumoniae antibodies. Conclusion: Although neither the prevalence nor the levels of single microbial antibodies studied differed between the patients and the controls, current data suggest that the presence of single or multiple antibodies in patients with many recurrences of AAU compared with patients with none or few recurrences may be a sign of repeated infections, antigen persistence, or raised innate immune responsiveness.