Article
Elevated antibody levels against Chlamydia, Borrelia and Ehrlichia cannot discriminate patients with axial spondyloarthritis from non-specific low back pain
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Authors
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Louise Thuesen Hermansen
- King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark; Institute for Regional Health Research, University of Southern Denmark, Denmark
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A. G. Loft
- Department of Medicine, Hospital Lillebælt, Vejle, Denmark; Department of Rheumatology, Aarhus University Hospital, Denmark
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A. A. Christiansen
- King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark; Institute for Regional Health Research, University of Southern Denmark, Denmark
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L. Gilbert
- Department of Biology and Environmental and Nano Science, University of Jyväskylä, Finland
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K. Garg
- Department of Biology and Environmental and Nano Science, University of Jyväskylä, Finland
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K. Karvonen
- Department of Biology and Environmental and Nano Science, University of Jyväskylä, Finland
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A. G. Jurik
- Department of Radiology, Aarhus University Hospital, Aarhus, Denmark; Research Department Spine Centre of Southern Denmark, Middelfart, Denmark
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U. Weber
- King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark
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B. Arnbak
- Institute for Regional Health Research, University of Southern Denmark, Denmark; Research Department Spine Centre of Southern Denmark, Middelfart, Denmark
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C. Manniche
- Institute for Regional Health Research, University of Southern Denmark, Denmark; Research Department Spine Centre of Southern Denmark, Middelfart, Denmark
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T. S. Jensen
- Institute for Regional Health Research, University of Southern Denmark, Denmark; Research Department Spine Centre of Southern Denmark, Middelfart, Denmark
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M. Østergaard
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet – Glostrup, Copenhagen, Denmark
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S. J. Pedersen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet – Glostrup, Copenhagen, Denmark
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T. Barington
- Department of Clinical Immunology, Odense University Hospital, Odense, Denmark
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H. J. Kolmos
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
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K. Hørslev-Petersen
- King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark; Institute for Regional Health Research, University of Southern Denmark, Denmark
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O. Hendricks
- King Christian 10th Hospital for Rheumatic Diseases, Gråsten, Denmark; Institute for Regional Health Research, University of Southern Denmark, Denmark
| Published: | September 30, 2016 |
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Outline
Text
Triggering bacterial infections have been considered part of the cause of spondyloarthritis (SpA). In this study, we investigated whether antibody titers against Chlamydia pneumoniae, Chlamydia trachomatis, Borrelia burgdorferi, Borrelia garinii, Borrelia afzelii, and Ehrlichia could be used to discriminate patients with axial spondyloarthritis (axSpA) from patients with non-specific low back pain (LBP).
IgG and IgM antibody titers against C. pneumoniae, C. trachomatis, B. burgdorferi, B. garinii, B.afzelii, and Ehrlichia were measured in: 96 patients with axSpA according to Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axSpA; 38 patients not meeting the ASAS criteria (non-axSpA) but having either a “positive MRI” as defined by ASAS or a positive HLA-B27 status plus one clinical SpA feature; 82 non-specific LBP patients, and 40 randomly selected blood donors (BD).
Antibody titers were compared between groups, and analyzed for correlation with patient characteristics. No statistically significant differences were found for antibody titers against any of the pathogens between axSpA, non-axSpA and LBP groups and no statistically significant correlations were found for antibody titers and patient characteristics age, gender, HLA-B27, hsCRP, and radiographic sacroiliac joint lesions. Our results suggest that elevated antibody titers against Borrelia, Ehrlichia and Chlamydia species are not discriminative markers for the diagnosis of axSpA among patients with persistent low back pain.
However, the results demonstrated a higher degree of polymicrobial events in axSpA patients fulfilling the mNYc and AS patients. This supports the hypothesis of polyinfections, i.e. that a sum of past infectious encounters could be a possible cause in driving the axSpA disease process towards a more chronic phenotype.
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