Bacterial diversity in temperomandibular joint synovial fluid in JIA

[Marky90]

"Temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA) occurs in up to 80% of affected children. The purpose of this study was to investigate the presence of bacterial DNA in synovial fluid, and to compare this with clinical and immunological findings in children with JIA, adults with persistent JIA, and adults with rheumatoid arthritis, in order to detect whether bacteria contribute to inflammation in TMJ arthritis. Synovial fluid and skin swab samples were collected from 30 patients (54 TMJs). Bacterial detection was performed using 16S rRNA pyrosequencing. Bacterial DNA was detected in 31 TMJs (57%) in 19 patients (63%). A positive statistically significant correlation was registered between bacterial DNA detected in TMJ synovial fluid and the following factors: total protein concentration in synovial fluid, interleukin 1β, tumour necrosis factor alpha, adrenocorticotropic hormone, and adiponectin, as well as the duration of the general medical disease. Fourteen different bacterial species were detected in synovial fluid. Bacterial DNA in TMJ synovial fluid without contamination was detected in more than 50% of the patients. Studies are needed to evaluate the consequences of this bacterial DNA in synovial fluid with regard to TMJ arthritis."

http://www.ncbi.nlm.nih.gov/pubmed/26554824

What does this mean when it comes to rituximab-usage for this group @Jonathan Edwards ?

 

[msf]

Do JIAs get Ritux? I wasn´t aware that they did. I could be wrong, but JIA seems like a wastebasket diagnosis (hence the idiopathic) and probably includes a lot of patients with a non-classic presentation of ReA. Since bacteria have been detected in the sinovial joints of ReA patients, I´m not surprised by this new finding.

 

[msf]

It would have been nice to know what bacteria they found though. And also whether they found any in the RA group.

 

[msf]

By the way, does this from the Wikipedia JIA page sound familiar? ´Children may also become quite ill, presenting with flu-like symptoms that persist´

 

[Jonathan Edwards]

"Temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA) occurs in up to 80% of affected children. The purpose of this study was to investigate the presence of bacterial DNA in synovial fluid, and to compare this with clinical and immunological findings in children with JIA, adults with persistent JIA, and adults with rheumatoid arthritis, in order to detect whether bacteria contribute to inflammation in TMJ arthritis. Synovial fluid and skin swab samples were collected from 30 patients (54 TMJs). Bacterial detection was performed using 16S rRNA pyrosequencing. Bacterial DNA was detected in 31 TMJs (57%) in 19 patients (63%). A positive statistically significant correlation was registered between bacterial DNA detected in TMJ synovial fluid and the following factors: total protein concentration in synovial fluid, interleukin 1β, tumour necrosis factor alpha, adrenocorticotropic hormone, and adiponectin, as well as the duration of the general medical disease. Fourteen different bacterial species were detected in synovial fluid. Bacterial DNA in TMJ synovial fluid without contamination was detected in more than 50% of the patients. Studies are needed to evaluate the consequences of this bacterial DNA in synovial fluid with regard to TMJ arthritis."

http://www.ncbi.nlm.nih.gov/pubmed/26554824

What does this mean when it comes to rituximab-usage for this group @Jonathan Edwards ?

I doubt it means anything. We have known for decades that bacterial debris gets into blood and also into tissues in normal people. Schumacher should bacterial debris by EM in joints the 1970s. Synovial tissue has fenestrated capillaries so probably gets more junk in it than other tissues. But this is all debris as far as I know - tiny bits of stuff, not live organisms. Finding bacterial DNA in joint fluid would be pretty much expected I think if you use sensitive amplification.

JIA is not a wastebasket. It is an umbrella term for at least six well defined subcategories, some of which overlap and some of which do not. It has always seemed to me to be too imprecise either for clinical or scientific purposes - that I would agree. I think a weakness of this study is that it gives us no idea which categories were involved - at least in the abstract.