Denys K. Ford

PERSISTENT RUBELLA INFECTION AND RUBELLA-ASSOCIATED ARTHRITIS

Rubella virus has been isolated from peripheral blood lymphocytes in six out of seven women with rubella-associated arthritis. The arthritis occurred after natural infection (one case) or immunisation with HPV 77 DES vaccine (six cases) and had been present for up to 6 years. The identification of rubella virus was confirmed by plaque/microfocus reduction in the presence of anti-rubella antiserum, and by immunoprecipitation of rubella virus antigens and their analysis on polyacrylamide gels. These women with rubella virus in their lymphocytes did not have abnormal serum antibody levels, but a standard lymphoproliferative assay showed that they had strong cell-mediated immune responses to rubella virus antigens.

Lymphocytes from the site of disease but not blood lymphocytes indicate the cause of arthritis.

The [3H]thymidine uptake procedure for measuring lymphocyte responses was applied to lymphocytes derived concurrently from synovial effusions and from peripheral blood. The stimulating antigens were crude preparations of those micro-organisms that are related to the enteritis and the non-gonococcal urethritis that precipitate reactive arthritis. Salmonella, shigella, and campylobacter antigens stimulated synovial but not peripheral blood lymphocytes in eight cases of enteric reactive arthritis. Ureaplasma or chlamydia antigens, or both, stimulated synovial lymphocytes in all 12 cases of sexually transmitted reactive arthritis, whereas peripheral blood lymphocytes were only stimulated in four of the 12 cases. In 14 cases of rheumatoid arthritis reactions to either enteric or ureaplasma/chlamydia antigens were minimal from either synovial or peripheral blood lymphocytes. It is concluded that synovial rather than peripheral blood lymphocytes indicate the microbiological cause of reactive arthritis and that similar studies of lymphocytes from the site of local disease might be productive in other diseases.

Familial lipochrome pigmentation of histiocytes with hyperglobulinemia, pulmonary infiltration, splenomegaly, arthritis and susceptibility to infection

Abstract Three sisters, aged twenty-six, twenty-one and sixteen, were discovered to have a similar disease characterized by lipochrome granulation of histiocytes, hyperglobulinemia, splenomegaly and pulmonary infiltrations. In addition, the twenty-six year old subject had marked susceptibility to infection, the twenty-one year old sister had transient episodes of arthritis, and the sixteen year old had juvenile rheumatoid arthritis with nodules. Histiocytes containing lipochrome-pigmented granules were found in biopsy specimens from all three girls and in the sputum of one. Rheumatoid factor was present in each girl and the serum of one, when examined by ultra-centrifugation, showed a small amount of globulin with a faster sedimentation rate than the 19S globulins. The hyperglobulinemia consisted mainly of an increase in gamma globulin but the alpha 2 globulins were also increased. No abnormalities were detected in serum lipids and no hepatic or renal dysfunction was demonstrable. Blood platelet counts were moderately elevated in the sixteen year old girl and slightly elevated in the other two. The twenty-six year old woman with a susceptibility to infections had a poor typhoid H antibody response to T.A.B. vaccination. It is hypothesized that the lipochrome granulation of the histiocytes is the basic genetic defect, the other clinical and laboratory manifestations of the syndrome being secondary.

Reiter's syndrome: evaluation of proposed criteria.

Clinical entities in the seronegative spondyloarthropathies329 are difficult to delineate and overlap considerably. Classifying Reiters syndrome (RS) in particular is handicapped by the sporadic occurrence of the endemic disease, the transient nature of the disease in many cases, and the need for relatively long follow-up to establish the presence of x-ray changes. The presence of HLA-B27 has not contributed to resolving the problem for RS any more than it has for ankylosing spondylitis.37 Thus, in a first attempt, the American Rheumatism Association (ARA) Diagnostic and Therapeutic Criteria Committee has evaluated typical cases from seven university-based arthritis centres retrospectively in an attempt to develop diagnostic criteria for RS.

Sequential studies on synovial lymphocyte stimulation by rubella antigen, and rubella virus isolation in an adult with persistent arthritis.

The response of synovial lymphocytes from a 65-year-old lady with persistent polyarthritis, to rubella antigen and a number of other microbial agents was studied over a period of 11 months by [3H]thymidine incorporation. The results were correlated with the ability to isolate rubella virus from both peripheral blood and synovial fluid during the same period. The patient showed initially a maximal stimulation index to rubella antigen assayed on five occasions over a five-month period. Rubella virus was detected in both peripheral blood and synovial fluid samples on three occasions during this period. Five months later the lymphoproliferative response of her synovial lymphocytes to rubella antigen had dropped to low levels, and virus could no longer be isolated from synovial exudates. At this time the patients arthritis had become much less active, indicating that a good correlation existed between the presence of rubella virus, local lymphocyte sensitisation, and the inflammatory reaction.

Sequential follow up observations of a patient with rubella associated persistent arthritis.

In 1985 a patient was described whose persistent polyarthritis was found to be aetiologically linked to rubella virus infection through the detection of repeated maximal synovial lymphocyte proliferative responses to rubella virus antigen and by isolation of rubella virus from her synovium. Follow up over the succeeding seven years has shown continuing chronic polyarthritis and persistent synovial lymphocyte responses to rubella virus antigen with the additional observation that she has a defective humoral immune response against rubella virus.

Inhibition of Growth of T-Strain Mycoplasmas by Hydroxamic Acids and by Aurothiomalate

Sorbyl-, benzoyl-, and 3-amino-benzoyl hydroxamic acids inhibited the development of an alkaline pH by T-strain cultures grown in broth containing 0.05% urea and phenol red. The specificity of this urease inhibition was demonstrated by the inhibition, by 10−4m sorbyl-hydroxamic acid, of the release of 14CO2 from 14C-urea by washed T-strain mycoplasmas in 4 hr of incubation. Sorbyl-, benzoyl-, and 3-amino-benzoyl hydroxamic acids at a concentration of 10−3m markedly inhibited the multiplication of T-strain 354 during 18 hr of incubation; this inhibition was not corrected by thymidine at a concentration of 500 μg per ml. Aurothiomalate was 20 times more inhibitory to Mycoplasma hominis DC-63 than to T-strain 354; equivalent inhibitory concentrations were 50 μg per ml for M. hominis and 1,200 μg per ml for T strains.

Prolonged Arthritis in Identical Twins After Rubella Immunization

Excerpt The development of transient or recurrent arthritis has been reported after either wild-type rubella infection or immunization with the HPV-77 DK/12 or, more rarely, the HPV-77 DE/5 strain ...