Intraarticular and Circulatory Cytokine Responses to Chlamydia Trachomatis: A Clinical Study in Reactive Arthritis/ Undifferentiated Spondyloarthropathy Patients

Sangita Rastogi¹, Praveen Kumar ², Darshan Bhakuni ³ and Geetika Khanna ⁴, ¹ICMR- National Institute of Pathology, Safdarjung hospital campus, New Delhi- 110 029, India, New Delhi, Delhi, India, ²ICMR- National Institute of Pathology, Safdarjung hospital campus, New Delhi- 110 029, India, Kota, Rajasthan, India, ³Department of Rheumatology and Clinical Immunology, Army Hospital (Research & Referral), Dhaula Kuan, New Delhi- 110 010, India, New Delhi, Delhi, India, ⁴Central Institute of Orthopedics (CIO), Vardhaman Mahavir Medical College (VMMC) & Safdarjung hospital, New Delhi-110029, India, New Delhi, Delhi, India

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: cytokines and pathogenesis, Reactive arthritis, synovial fluid

Session Information

Date: Sunday, November 10, 2019

Title: Cytokines & Cell Trafficking Poster

Session Type: Poster Session (Sunday)

Session Time: 9:00AM-11:00AM

Background/Purpose: Chlamydia trachomatis-induced reactive arthritis (ReA)/ undifferentiated spondyloarthropathy (uSpA) is an immune-mediated situation where development of disease and maintenance of this pathogen remains elusive. The aim of the study was to estimate the peripheral and localized Th1/ Th2/ Th17 cytokine responses in paired synovial fluid (SF) and serum samples in genitourinary ReA/ uSpA patients infected with C. trachomatis.

Methods: With hospital ethical permission, ReA/ uSpA (n = 45)/ Rheumatoid Arthritis (RA) (n = 35)/ Osteoarthritis (OA) (n = 35) patients were enrolled following European spondyloarthropathy study group criteria for ReA/ uSpA and American College of Rheumatology for RA; while OA patients were diagnosed on the basis of clinical and radiological findings. Clinical profile of all arthritic patients was recorded and SF and blood (serum) were collected from each patient. Commercially available kits were used for estimation of SF/ serum cytokines and serum chsp60 by Elisa and HLA B27 by PCR in SF DNA. Statistical analysis of data was done by GraphPad Prism software version 5.0 (GraphPad software, La Jolla, CA, USA).

Results: IFN-gamma was significantly (‘p’ = 0.0003) elevated in the SF of C. trachomatis-positive ReA/ uSpA patients while it was non-significant (‘p’ = 0.06) in serum. IL-4 was significantly higher in SF (‘p’ = 0.01) and serum (‘p’ = 0.006) of C. trachomatis-infected ReA/ uSpA patients in comparison to uninfected ReA/ uSpA, RA and OA patients. IL-17 was comparable (‘p’ = 0.9) in SF and serum of C. trachomatis-infected and uninfected ReA/ uSpA patients and RA. SF and serum IFN-gamma were positively correlated (r = 0.28; p < 0.05); IL-6 and IFN-gamma in SF were also positively correlated (r = 0.72; p < 0.007) in ReA/ uSpA patients. IFN-gamma was slightly high (‘p’ > 0.05, non-significant) in chsp60-positive patients while it was low in HLA B27-positive patients with C. trachomatis infection.

Conclusion: Synergistic upregulation of IFN-gamma in SF and serum shows Th-1 dominant immune response which is probably mediated by IL-6 in C. trachomatis-induced ReA/ uSpA. HLA B27 and chsp60 do not play any significant role during C. trachomatis-induced ReA/ uSpA.

Disclosure: S. Rastogi, None; P. Kumar, None; D. Bhakuni, None; G. Khanna, None.

To cite this abstract in AMA style:

Rastogi S, Kumar P, Bhakuni D, Khanna G. Intraarticular and Circulatory Cytokine Responses to Chlamydia Trachomatis: A Clinical Study in Reactive Arthritis/ Undifferentiated Spondyloarthropathy Patients [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/intraarticular-and-circulatory-cytokine-responses-to-chlamydia-trachomatis-a-clinical-study-in-reactive-arthritis-undifferentiated-spondyloarthropathy-patients/. Accessed .

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