A potential role for chlamydial infection in rheumatoid arthritis development
2023

Chlamydial Infection and Rheumatoid Arthritis Development

Sample size: 1231 publication 10 minutes Evidence: moderate

Author Information

Author(s): Lamacchia Celine, Aymon Romain, Hattel Brian C, Aeby Sebastien, Kebbi-Beghdadi Carole, Gilbert Benoit, Studer Olivia, Norris Jill M, Nolers V Michael, Demoruelle M Kristen, Feser Marie L, Moss Laura Kay, Courvoisier Delphine S, Lauper Kim, Deane Kevin D, Greub Gilbert, Finckh Axel

Primary Institution: Geneva University Hospital and Faculty of Medicine, University of Geneva

Hypothesis

Is there a relationship between chlamydial infection and the development of rheumatoid arthritis (RA) autoimmunity?

Conclusion

Self-reported chlamydial infections are associated with elevated RA autoimmunity in at-risk individuals.

Supporting Evidence

  • Among 1231 RA-FDRs, 168 (13.6%) developed RA autoimmunity.
  • Prevalence of self-reported chlamydial infection was significantly higher in individuals with RA autoimmunity compared with controls (17.9% vs 9.8%).
  • The association remained significant after adjustments with an odds ratio of 1.91.
  • Stronger effect sizes were observed in later stages of RA development.
  • Similar trends were observed in a replication cohort in the USA.

Takeaway

People who had chlamydia infections might be more likely to develop a condition that can lead to rheumatoid arthritis, especially if they have family members with the disease.

Methodology

This study analyzed self-reported chlamydial infections and serological evidence in a cohort of first-degree relatives of RA patients.

Potential Biases

Response bias may occur if participants are aware of their chlamydial infection status when answering the questionnaire.

Limitations

The study may have false-positive serology results and relies on self-reported data, which can be biased.

Participant Demographics

The cohort included 1231 first-degree relatives of RA patients, predominantly women (75.6%) with a mean age of 49.8 years.

Statistical Information

P-Value

p<0.01

Confidence Interval

95% CI: 1.20, 2.95

Statistical Significance

p<0.01

Digital Object Identifier (DOI)

10.1093/rheumatology/kead682

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