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Chlamydia-induced ReA: immune imbalances and persistent pathogens

Nature Reviews Rheumatology volume 8, pages 55–59 (2012)Cite this article

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Abstract

Reactive arthritis (ReA), an inflammatory arthritic condition that is commonly associated with Chlamydia infections, represents a significant health burden, yet is poorly understood. The enigma of this disease is reflected in its problematic name and in its ill-defined pathogenesis. The existence of persistent pathogens in the arthritic joint is acknowledged, but their relevance remains elusive. Progress is being made in understanding the underlying mechanisms of ReA, whereby an imbalance between type 1 and type 2 immune responses seems to be critical in determining susceptibility to disease. Such an imbalance occurs prior to the initiation of an adaptive immune response, suggesting that innate cellular and molecular mechanisms in ReA should be prioritized as fruitful areas for investigation.

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Figure 1: The relationship between spondyloarthritis, reactive arthritis, and septic arthritis.
Figure 2: Outcomes of a type 1 dominant versus type 2 dominant inflammatory response during chlamydial infection.

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  1. Toronto Western Hospital, 399 Bathurst Street, Toronto, M5T 2S8, ON, Canada

    Eric Gracey & Robert D. Inman

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  1. Eric Gracey
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E. Gracey researched data for the article. Both authors contributed equally to discussing the content, writing the article and performing review/editing of the manuscript before submission.

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Correspondence to Robert D. Inman.

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Gracey, E., Inman, R. Chlamydia-induced ReA: immune imbalances and persistent pathogens. Nat Rev Rheumatol 8, 55–59 (2012). https://doi.org/10.1038/nrrheum.2011.173

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