What are other potential factors involved in the pathogenesis of Reactive Arthritis?
Since patients who are HLA-B27-negative also develop ReA, other focus of investigations favors the role of microbial factors.
Some examples of these theories are: the ability of certain outer membrane proteins of some of the involved organisms ( Salmonella ) to stimulate specific interleukin (IL) responses (IL-17 and IL-23) in synovial cells; finding metabolically active particles ( Chlamydia ) in the synovial tissue of patients with chronic ReA; and alteration of the gut microbiota leading to an abnormal immune response.
