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Infection and Immunity, March 2001, p. 1821-1831, Vol. 69, No. 3
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

Karen E. Kempsell,1,* Charles J. Cox,2 Andrew A. McColm,1 Julie A. Bagshaw,1 Richard Reece,3 Douglas J. Veale,3 Paul Emery,3 John D. Isaacs,3 J. S. Hill Gaston,2 and J. Scott Crowe1

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.


* 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.


Infection and Immunity, March 2001, p. 1821-1831, Vol. 69, No. 3
0019-9567/01/$04.00+0   DOI: 10.1128/IAI.69.3.1821-1831.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.



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