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Do infections trigger juvenile idiopathic arthritis?

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Abstract

Juvenile idiopathic arthritis (JIA) is a disease that was prominent with increased inflammation response in immune system, appeared mostly with peripheral arthritis and endogenous and exogenous antigens play a role in the pathogenesis of disease. Two major reasons were thinking to be considerably important. First of them is immunological predisposition and the second one is environmental factors. Infections are considered to be the most important between environmental factors but also stress and trauma are also important in the etiology of the disease. However, the relation between JIA and infections is not clearly defined but the relation between adult chronic arthritis and infections was well-defined. A total of 70 patients, 26 with primer JIA, 20 with recurrent JIA, 24 healthy control were included in this study. Mycoplasma pneumoniae, Chlamydophila pneumoniae and C. Jejuni were detected in 4, 1 and 1 of 10 (38.46%) patients with primer JIA, respectively. Salmonella enteritidis, EBV, M. pneumoniae, C. jejuni and Borrelia burgdorferi were detected in 1, 2, 2, 2, and 1 of the 8(40%) patients with recurrent JIA, respectively. S. enteritidis were isolated in feces culture and also identified by agglutination method. Infection was detected in total 18 (39.13%) of patient groups. C. pneumoniae and C. jejuni were detected in 1 and 1 of 2(8.33) healthy control groups, respectively. Throat culture positivity was not detected in any of the patient and healthy control groups. In conclusion, etiopathogenesis of JIA is not clearly understood and suggested that various factors can trigger the disease and it is the most common rheumatoid disease of childhood. However, there are some studies focusing especially on one infectious agent but this is the first study including such a big range of infectious agents in the literature for the microorganisms that can be suggested to have a role in the etiopathogenesis of JIA. We have a conclusion in the light of our results and suggest that some microorganisms can trigger and increase the intensity of clinical situation according to the case. When we evaluate the primer and recurrent JIA groups; M. pneumoniae and C. jejuni come forward and seen common in JIA cases. We also suggest that the pre-diagnosis of microorganisms, which can play a role as primarily or by intervening in the etiopathogenesis of JIA and adding specific antimicrobial therapy to the standard JIA therapy, it is possible to perform new, extended, especially molecular based serial case studies.

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References

  1. Schneider R, Passo MH (2002) Juvenile rheumatoid arthritis. Rheum Dis Clin N Am 28:503–530

    Article  Google Scholar 

  2. Weiss JE, Ilowite NT (2005) Juvenile idiopathic arthritis. Pediatr Clin North Am 52:413–442

    Article  PubMed  Google Scholar 

  3. Carty SM, Snowean N, Silman AJ (2003) Should infection still be considered as the most likely triggering factor for RA? J Rheumatol 30:425–429

    PubMed  Google Scholar 

  4. Petty RE, Southwood T, Baum J et al (1998) Revision of the proposal classification criteria for Juvenile idiopathic arthritis. J Rheumatol 25:1991–1994

    CAS  PubMed  Google Scholar 

  5. Petty RE, Cassidy JT (2005) Chronic arthritis. In: Cassidy JT, Petty RE (eds) Textbook of pediatric rheumatology, 5th edn. Elsevier, Philadelphia, pp 206–341

    Google Scholar 

  6. Hannu T, Puolakkainen M, Leirisalo-Repo M (1999) Chlamydia pneumoniae as a triggering infection in reactive arthritis. Rheumatology 38:411–414

    Article  CAS  PubMed  Google Scholar 

  7. Brunner HI, Lovell DJ, Finck BK, Giannini EH (2002) Preliminary definition of disease flare in juvenile rheumatoid arthritis. J Rheumatol 29(5):1058–1064

    PubMed  Google Scholar 

  8. Brunner HI, Ivaskova E, Haas JP, Andreas A, Keller E, Hoza J, Havelka S, Scholz S, Sierp G, Albert ED (1993) Class I associations and frequencies of class II HLA-DRB alleles by RFLP analysis in children with rheumatoid-factor-negative juvenile chronic arthritis. Rheumatol Int 13:83–88

    Article  CAS  PubMed  Google Scholar 

  9. Haas JP, Kimura A, Truckenbrodt H, Suschke J, Sasazuki T, Volgger A, Albert ED (1995) Early-onset pauciarticular juvenile chronic arthritis is associated with a mutation in the Y-box of the HLA-DQA1 promoter. Tissue Antigens 45(5):317–321

    Article  CAS  PubMed  Google Scholar 

  10. Albert LJ (2000) Infection and rheumatoid arthritis: guilty by association? J Rheumatol 27:564–566

    CAS  PubMed  Google Scholar 

  11. Johnson RM, Brown EJ (2000) Cell-mediated immunity in host defense against infectious diseases. In: Mandell GL, Bennet JE, Dolin R (eds) Principles and practice of infectious diseases, 5th edn. Churchill Livingstone, Philadelphia, p 113

    Google Scholar 

  12. Benedek TG (2006) The history of bacteriologic concepts of rheumatic fever and rheumatoid arthritis. Semin Arthritis Rheum 36(2):109–123 (epub 13 July 2006)

    Article  PubMed  Google Scholar 

  13. Hannu T, Inman R, Granfors K, Leirisalo-Repo M (2006) Reactive arthritis or post-infectious arthritis? Best Pract Res Clin Rheumatol 20(3):419–433

    Article  PubMed  Google Scholar 

  14. Yang J, Hooper WC, Phillips DJ, Talkington DF (2004) Cytokine growth. Factor Rev 15(2-3):157–168

    Article  CAS  Google Scholar 

  15. Mardh A (2004) Mycoplasma and ureaplasma. In: Cohen J, Powderly W (eds) Infectious disease, 2nd edn. Elsevier, Philadelphia, p 2309

    Google Scholar 

  16. Sibilia J, Limbach F-X (2002) Reactive arthritis or chronic infectious arthritis? Ann Rheum Dis 61:580–587

    Article  CAS  PubMed  Google Scholar 

  17. Villareal C, Whittum-Hudson JA, Hudson AP (2002) Persistent Chlamydiae and chronic arthritis. Arthritis Res 4:5–9

    Article  PubMed  Google Scholar 

  18. Taylor-Robinson D, Rooney M (1998) Association of Chlamydia pneumoniae with chronic juvenile arthritis. Eur J Clin Microbiol Infect Dis 17:211–216

    CAS  PubMed  Google Scholar 

  19. Altun S, Kasapçopur O, Aslan M, Karaarslan S, Koksal V, Saribaş S, Ergin S, Arisoy N, Kocazeybek B (2004) Is there any relationship between Chlamydophila pneumoniae infection and juvenile idiopathic arthritis? J Med Microbiol 53:787

    Article  PubMed  Google Scholar 

  20. Montgomery RR, Malawista SE, Feen KJM, Bockenstedt LK (1996) Direct demonstration of antigenic substitution of Borrelia burgdorferi ex vivo: exploration of the paradox of the early immune response to outer surface proteins A and C in Lyme disease. J Exp Med 183:261–269

    Article  CAS  PubMed  Google Scholar 

  21. Gross DM, Forsthuber T, Tary-Lehmann M, Etling C, Ito K, Nagy ZA et al (1998) Identification of LFA-1 as a candidate autoantigen in treatment-resistant Lyme arthritis. Science 281:703–706

    Article  CAS  PubMed  Google Scholar 

  22. Gear AJ, Venables PJW, Edwards JMB, Maini RN (1986) Rheumatoid arthritis, juvenile arthritis, iridocyclitis and the Epstein-Barr virus. Ann Rheum Dis 45:6–8

    Article  CAS  PubMed  Google Scholar 

  23. Saarinen M, Ekman P, Ikeda M, Virtala M, Grönberg A, Yu DTY, Arvilommi H, Granfors K (2002) Invasion of Salmonella into human intestinal epithelial cells is modulated by HLA-B27. Rheumatology 41:651–657

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Microbiology and Clinical Microbiology Department, Cerrahpasa Medical Faculty, Istanbul University, Kocamustafapasa, 34303, Istanbul, Turkey

    Mustafa Aslan, Hatice Yasar, Erdal Polat, Suat Saribas, Müzeyyen Mamal Torun, Nil Arısoy & Bekir Kocazeybek

  2. Medical Sciences Department, Forensic Sciences Institute, Istanbul University, Istanbul, Turkey

    Huseyin Cakan

  3. Pediatric Department, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey

    Ozgur Kasapcopur & Nil Arısoy

  4. Department of Biostatistics, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey

    Ahmet Dirican

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  1. Mustafa Aslan
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  2. Ozgur Kasapcopur
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  3. Hatice Yasar
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  4. Erdal Polat
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  6. Huseyin Cakan
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  7. Ahmet Dirican
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  8. Müzeyyen Mamal Torun
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  9. Nil Arısoy
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  10. Bekir Kocazeybek
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Correspondence to Bekir Kocazeybek.

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Aslan, M., Kasapcopur, O., Yasar, H. et al. Do infections trigger juvenile idiopathic arthritis?. Rheumatol Int 31, 215–220 (2011). https://doi.org/10.1007/s00296-009-1253-4

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  • DOI: https://doi.org/10.1007/s00296-009-1253-4

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