Immune responses to borrelia burgdorferi in patients with reactive arthritis

Cornelia M. Weyand, Jörg J. Goronzy

Research output: Contribution to journalArticlepeer-review

54 Scopus citations


In reactive arthritis (ReA), including Reiter's syndrome, a close relationship between chronic enteric and genitourinary infections and the clinical features of enthesitis has been described. In contrast, in Lyme arthritis, a distinct clinical entity, chronic infection with the tick‐transmitted spirochete Borrelia burgdorferi has been associated with the disease. In a prospective study, 51 patients with ReA were tested for evidence of chlamydial and spirochetal infection. The presence of Chlamydia was determined by culture in 8 patients, and 7 additional patients had markedly elevated antibody titers. In 9 patients, antibodies specific to B burgdorferi were found. Purified peripheral blood T lymphocytes of all 9 patients proliferated specifically to stimulation with macrophages pre‐pulsed with B burgdorferi antigens. Compared with other protein antigens, higher numbers of antigen‐pulsed macrophages were necessary to activate B burgdorferi–specific T cells. Although antibody titers decreased in response to antibiotic treatment in 8 of 9 patients, second‐line therapy with sulfasalazine or methotrexate was required to obtain clinical remission. These data suggest that chronic infection with B burgdorferi can cause ReA. In predisposed individuals, the arthritogenic immune response might be triggered by persisting infectious agents independent of their antigenic specificities.

Original languageEnglish (US)
Pages (from-to)1057-1064
Number of pages8
JournalArthritis & Rheumatism
Issue number9
StatePublished - Sep 1989

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology
  • Pharmacology (medical)


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