Mycoplasmas in JRA Eye Disease?

The late Dr. Wirostko was a researcher and practicing ophthalmologist at Columbia Presbyterian Medical Center in New Jersey, specializing in infectious eye disease. His research in this area spans 20 years.

Dr. Wirostko and colleagues had published extensively on their findings of mycoplasma-like organisms (MLOs) in ophthalmic disease, especially uveitis in JRA patients.

Inflammation of the ocular vascular coats frequently accompany the joint disease of JRA. Upon testing, Dr. Wirostko found a prevalence of vitreous mycoplasma-like organisms in the inflamed eye fluids. These MLOs are cell wall deficient, pleomorphic, and can easily be confused with viruses. The intraocular fluids containing the MLO structures produced chronic uveitis and a systemic chronic inflammatory disease resembling human collagen vascular disease in experimental animals.

The MLOs parasitize the leukocytes and endothelial cells, and they appear to play an important part in the induction of lesions associated with this inflam matory eye disease. This dysfunction may in fact be responsible for disease progression.

The pathologic lesion is characterized as a vasculitis with subsequent tissue lysis, lyinphoid infiltration and granuloma formation. These MLOs, like most mycoplasmas, are fastidious and cannot be cultured in the laboratory. They are lipid-rich, and contain a variety of cytotoxic substances including nucleases.

MLOs have been identified in the eye disease of Crohns disease, sarcoidosis and JRA as well as other forms of orbital inflammatory disease. MLOs are well known plant pathogens and human MLOs seem to be very similar.

There are many reasons to believe these MLOs are also involved in human idiopathic systemic inflammatory disease such as JRA. We have found rifampin to be efficaciotis in both animal and human disease, eliciting a more rapid response than the tetracyclines and erythromycin which are slower acting but also efficacious.

References:

Mycoplasma like Organisms and Ophthalmic Disease, E Wirosiko, LA Johnson, BM Wirosiko, RL Farris, Thins. Amer Op/it/i Soc., 9 i :85. i 99?. p. 85-98.
Juvenite Rheumatoid Anhriiis intlanimalory Eye
Disease Parasitizatmon at Ocuitar Lcukocytcs by
Molticute like Organisms, .1 o/ Rheuni, i 6:1 i ,i 989.
p t446-i453.