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R. Cuchacovich, L. R. Espinoza, Lower level of synovial fluid interferon-γ in HLA-B27-positive than in HLA-B27-negative patients with Chlamydia trachomatis reactive arthritis, Rheumatology, Volume 43, Issue 2, February 2004, Pages 249–250, https://doi.org/10.1093/rheumatology/keg440
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Sir, We read with great interest the study by Bas et al. [1] in which they analysed synovial fluid (SF) cytokine levels in reactive arthritis (ReA), rheumatoid arthritis (RA) and osteoarthritis, and correlate them with the HLA-B27 haplotype in a subset of ReA patients positive for Chlamydia trachomatis. The results did not reveal significant differences in cytokine levels and ratios among the groups, although lower levels of interferon γ (IFN-γ) in SF were found in the HLA-B27-positive ReA patients than in the negative ones.
The data presented are striking, but they merit comment. First, the Quantikine ELISA kits used are not validated for use with SF. Therefore, it is fair to ask why these kits were used to analyse the SF.
Secondly, the lower levels of SF interleukin (IL) 10 in ReA than in RA are at variance with other reports. In addition, how do the authors explain the higher ratios of IFN-γ to IL-10 among the ReA patients? Animal models of Chlamydia infection have shown that the clearance of the organism is affected by the balance between IFN-γ and IL-10, and IL-10 gene knockout mice clear Chlamydia infection more rapidly than normal [2–4].
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