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Infection and Immunity, March 2001, p. 1821-1831, Vol. 69, No. 3
Glaxo Wellcome Medicines Research Centre,
Stevenage, Hertfordshire SG2 1NY,1
Department of Medicine, University of Cambridge School of
Clinical Medicine, Addenbrookes Hospital, Cambridge CB2
2QQ,2 and Department of Molecular
Medicine, St. James University Hospital, University of Leeds, Leeds LS9
7TF,3 United Kingdom
Received 27 July 2000/Returned for modification 9 October
2000/Accepted 8 December 2000
Infection with mycobacterial species, including Mycobacterium
tuberculosis, has long been implicated in the etiopathology of
rheumatoid arthritis (RA) on the basis of clinical and pathological similarities between tuberculosis and RA. Despite evidence of immune
responses to mycobacterial antigens in RA patient synovial fluid,
cross-reactivity between these and host joint antigens, and the
presence of M. tuberculosis protein antigen in RA synovial fluid, a definite causal association with RA has not been shown. Previous studies from our laboratory using reverse transcriptase PCR
(RT-PCR) of bacterial rRNAs have shown RA synovium to be colonized by a
diverse range of bacteria, most of commensal origin. However, M. tuberculosis group organism (MTG) RNA sequences were found in one
RA patient tissue. Since this was considered of sufficient interest to
warrant further investigation, we devised a M. tuberculosis-specific nested RT-PCR test which could be used for
detection of MTG in a mixed pool of bacterial crDNAs. This test was
used to investigate the distribution of MTG in RA synovial tissue and
also non-RA arthritis and healthy control tissues and was also used to
examine the tissue distribution of MTG in an acute and chronic model of M. tuberculosis infection in the BALB/c mouse. MTG
sequences were found in a high proportion of RA patient synovial
tissues but also in non-RA arthritis control tissues at lower
frequency. This likely reflects trafficking of persistent M. bovis BCG to inflamed joint tissue, irrespective of cause. MTG
were not found in healthy synovial tissue or the tissue of patients
with undifferentiated arthritis. In both the acute and chronic models
of infection in BALB/c mice, M. tuberculosis was also found
to have trafficked to joint tissues, however, no signs of inflammation,
arthritis, or pathology associated with M. tuberculosis
infection was seen. These combined results would argue against a
specific causal role of MTG in RA-like arthritis; however, their role
as adjuvant in immune dysfunction in an innately susceptible host
cannot be excluded.
0019-9567/01/$04.00+0 DOI: 10.1128/IAI.69.3.1821-1831.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Detection of Mycobacterium tuberculosis Group
Organisms in Human and Mouse Joint Tissue by Reverse Transcriptase PCR:
Prevalence in Diseased Synovial Tissue Suggests Lack of
Specific Association with Rheumatoid Arthritis
*
Corresponding author. Mailing address: Glaxo Wellcome
Medicines Research Centre, Department of Immunopathology, Gunnels Wood Road, Stevenage, Hertfordshire SG1 1NY, United Kingdom. Phone: (44)
1438 764975. Fax: (44) 1438 764818. E-mail:
kek23980{at}GlaxoWellcome.co.uk.
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