UREAPLASMA-UREALYTICUM IN REITERS-SYNDROME

Objective. To evaluate the role of Ureaplasma urealyticum (Uu) in the pathogenesis of Reiter's syndrome (RS). Methods. Infection with Uu was determined in 31 patients with RS and 28 patients with other arthriti des by urethral, cervical and synovial fluid (SF) culture and by measu ring anti-Uu serum antibody. Infection with Chlamydia trachomatis was determined by examining SF by a direct immuno-fluorescence technique, by a polymerase chain reaction and by measuring anti-C. trachomatis se rum antibody. The proliferative response of SF and peripheral blood mo nonuclear cells (PBMC) to Uu antigens in patients with RS was compared to that of a control group. The effect that treatment of 6 patients w ith RS with ciprofloxacin had on repeated cultures, on titer of anti-U u antibody and on mononuclear cell reactivity was measured sequentiall y. Results. The colonization rate of Uu in patients with RS (74%) was significantly greater than in patients with other arthritides (14%). G enital C. trachomatis isolation and serum anti-C. trachomatis antibody were uncommon in both groups (11 and 13%, respectively). SF mononucle ar cells of the patients with RS proliferated specifically in response to Uu antigens [up to 6.9 stimulation index (SI)], as did their PBMC (up to 14.5 SI). In some patients, high anti-Uu antibody titers were m easured in the serum. Clinical remission was observed in 4 of 6 patien ts and correlated with eradication of Uu, decrease in antibody titers and disappearance of mononuclear cell reactivity to Uu antigens. Concl usion. Our findings suggest that Uu might be a causative agent or a tr igger in the development of sexually acquired RS.