A STUDY OF THE ROLE OF PARVOVIRUS B19 IN RHEUMATOID-ARTHRITIS

Serum and synovial tissue from 26 patients with rheumatoid arthritis ( RA) (according to the diagnostic criteria of the American Rheumatism A ssociation) and 26 patients with osteoarthritis (OA) were examined. Am ong the RA group, the female to male ratio was 4.2:1, and the age rang e was 44-82 yr with a mean of 64.0 yr; joints from which synovium was sampled were hip (n = 12), knee (n = 9), ankle (n = 3) and shoulder (n = 2). The duration of rheumatoid disease ranged from 6 to 24 yr with a mean of 13.9 yr. Among the OA group, the female to male ratio was 2. 25:1, and the age range was 51-88 yr with a mean of 68.2 yr; joints fr om which synovium was sampled were hip (n = 18) and knee (n = 8). Twen ty-one patients from the RA group and 20 patients from the OA group ha d evidence of previous parvovirus B19 infection (serum anti-B19 IgG), and all patients from both groups were serum anti-Bls IgM negative. Sy novial sections from all 52 patients were stained with mouse monoclona l antibodies, 3H8 (to B19 capsid proteins) and alpha-P (to blood group P antigen). All tissue sections examined were found to be negative fo r both B19 capsid proteins and blood group P antigen. Using a nested p olymerase chain reaction (PCR) assay, all patients were negative for s erum B19 DNA. However, B19 DNA was demonstrated in the synovium of 10 of 26 RA patients and 9 of 26 OA patients; uncorrected chi(2) value = 0.08; degrees of freedom = 1; P = 0.77. All 19 patients testing positi ve for synovial B19 DNA had evidence of prior exposure to B19 infectio n (serum anti-B19 IgG). In conclusion, although there is published evi dence of chronic rheumatoid-like arthropathy following acute parvoviru s B19 infection: our findings do not support the involvement of B19 in the aetiopathogenesis of RA.