Reactive arthritis pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pathophysiology
It is thought that reactive arthritis is the result of previous gastrointestinal or genitourinary infections especially with previous Chlamydia infection.
- Reactive arthritis is associated with HLA-B27 (MHC class I molecule).
- It is estimated around 75% patients of reactive arthritis are positive for HLA-B27.
- HLA B27 association with reactive arthritis can also be attributed to the fact that patients with family history of reactive arthritis tend to have a more severe form of disease.
- The exact mechanism by which infecting organism cause reactive arthritis is not fully understood.
- It is thought that microbial antigens are similar to certain body proteins (self proteins) and when the host immune system gets activated and releases antibodies, it leads to an autoimmune condition leading to destruction of self proteins and symptoms of reactive arthritis.
- Activation of host immune system generally activates the TH2 helper cells which lead to increased antibody production and subsequent destruction.
- Furthermore, studies have shown that analysis of synovial fluid has shown the presence of T cells and intra-articular antibody.