RELATIONSHIP BETWEEN FOODBORNE BACTERIAL PATHOGENS AND THE REACTIVE ARTHRITIDES

Certain individuals suffer complications after diarrheic episodes caus ed by Campylobacter, Salmonella, Shigella, or Yersinia. One of these c omplications may be a sterile arthritis such as reactive arthritis, Re iter's syndrome and anklylosing spondylitis. Reactive arthritis and Re iter's syndrome have been shown to have a bacterial etiology; however, such etiology, while suspected, has not been definitely confirmed for ankylosing spondylitis. These arthritides show a strong familial asso cation and here, reactive arthritis, Reiter's syndrome and ankylosing spondylitis are characterized and the relationship of the diseases to the major histocompatility complex antigen, HLA-B27, is described. Stu dies have indicated that there may be molecular mimicry between certai n microbial antigens and HLA-B27. Molecular mimicry is discussed in te rms of its possible explanation of the etiology of the reactive arthri tides. The roles of antibodies, lymphocytes, bacterial antigens, and s tress proteins in the symptomology of the arthritides are reviewed.