Chlamydophila pneumoniae infection is not associated with primary biliary cholangitis / La infección por Chlamydophila pneumoniae no está asociada con colangitis biliar primaria

ANTECEDENTES: La colangitis biliar primaria (CBP) es una enfermedad hepática inflamatoria crónica colestásica de causa desconocida. Varios patógenos virales y bacterianos han sido propuestos como factores que podrían gatillar una respuesta inmune por mimetismo molecular, o directamente estar relacionados en la persistencia del daño biliar. Existen reportes controversiales respecto al rol de en la patogenia de CBP. OBJETIVOS: Investigar marcadores de infección de séricos y en hígado de pacientes con CBP. PACIENTES Y MÉTODOS: Veinte pacientes diagnosticados con CBP y 20 pacientes control con otras enfermedades hepáticas crónicas no colestásicas fueron estudiados. Se determinaron anticuerpos séricos anti- (IgG). Se realizó detección inmunohistoquímica de antígenos de en hígado. Se extrajo DNA de hígado para amplificación de la secuencia específica de rRNA 16S de por PCR. Fueron usados controles de amplificación de DNA bacteriano y humano. Los pacientes firmaron consentimiento informado. Se realizó un metaanálisis de la diferencia de riesgo de CBP en pacientes infectados por y en un grupo control. RESULTADOS: Los anticuerpos séricos fueron positivos en 30% de los pacientes con CBP y 50% de los controles (p = NS). Antígenos de no fueron detectados en tejido hepático de pacientes con CBP ni de controles. No se amplificó ADN bacteriano en ninguna de las muestras. El metaanálisis de la diferencia de riesgo mostró gran heterogeneidad de los estudios, por lo que no se realizó una estimación de diferencia de riesgo agrupada. DISCUSIÓN: No encontramos asociación entre infección por y CBP. En la evidencia actual, un estudio presenta resultados a favor de la asociación entre y CBP y tres estudios resultados en contra.,

Primary biliary cholangitis (PBC) is a chronic cholestatic inflammatory liver disease of unknown cause. Several viral and bacterial pathogens have been proposed as factors that could either trigger an immune response by molecular mimicry or directly be involved in the persistence of biliary damage. There are conflicting reports respecting the role of in the pathogenesis of PBC. To investigate markers of infection in serum and liver tissue from patients with PBC. Twenty patients with diagnosis of PBC and 20 control patients with other non-cholestatic chronic liver diseases were studied. Serum anti- antibodies (IgG) were determined. Liver tissue was available for immunohistochemistry detection of antigens. DNA was extracted from liver tissue and a specific sequence of 16S rRNA gene was amplified by CPR. Adequate controls of bacterial and human DNA amplification were used. Informed consent was obtained from patients. A meta-analysis of risk difference of PBC in Chlamydophila pneumoniae infected patients and in the control groupwas performed. Serum antibodies were positive in 30% of patients with PBC and 50% of controls (p = NS). antigens were not detected in liver tissue neither of patients with PBC nor controls. Bacterial DNA did not amplify in any of the samples, despite good amplification of internal and external controls. Risk difference meta-analysis showed high heterogeneity between studies. Therefore, we did not estimate a pooled risk difference. Our results do not support the association between infection and PBC. In the current literature only one study shows an association between and PBC, but other three studies do not support it.

possible role for chlamydia pneumoniae in vaso-occlusive crisis in sickle cell disease

Vaso-occlusive crisis [VOC] is the most common complication in sickle cell disease [SCD]; it causes a wide spectrum of end-organ damage, a process found to be mediated by inflammatory responses. Through activating endothelial and immune cells, Chlamydia pneumoniae [Cp] infection was postulated to be a factor in the morbidity of acute chest syndrome in sickle cell patients [SCP]. To provide serological evidence of a possible role of Cp in VOC in SCD by investigating the occurrence of Cp IgG and IgA antibodies in SCD patients compared to control subjects. Open Controlled Trial. Bahrain Defense Force Hospital and Princess Al Jawhara Center for Molecular Medicine, Arabian Gulf University Bahrain. Venous blood samples were collected from one hundred and twelve patients who had acute phase of VOC and from one hundred and twelve controls. Anti-Cp IgG and IgA antibodies were detected by using species specific Cp IgG and IgA enzyme immunoassay [EIA] kits, in both patients and controls sera. Parametric comparisons were performed using t-test. The results showed a significant difference in Cp IgG and IgA antibodies prevalence between patients and controls [P<0.0001]. Dual Cp IgG and IgA seropositive were higher in patients than controls. The study provided serological evidence of a possible role of Cp infection in VOC in the SCD

Chlamydia pneumoniae and stroke: is there a direct relationship? / Chlamydia pneumoniae e acidente vascular cerebral aterotrombótico: existe relação direta?

OBJECTIVE: To investigate the possible relationship between atherothrombotic stroke and Chlamydia pneumoniae. METHOD: 150 patients with carotid atherothrombosis were enrolled. The casuistic was divided in three groups: ischemic stroke (IS): 65 patients; transient ischemic attack (TIA): 26 patients; and control: 59. The IS or TIA onset was up to 30 days from the beginning of the study. Carotid atheromatoses was diagnosed by Doppler-ultrasonography. Patients with cardioembolic risk or non-atherothrombotic origin were excluded. Comparisons were done between the three groups, and within each group according to the different age sub-groups, to the main arteries affected, and to the atherogenic risk factors. Bacteria detection was done using polimerase chain reaction. RESULTS: Only one patient tested positive for C. pneumoniae belonging to the control group. CONCLUSION: These results do not suggest that C. pneumoniae participated in the onset of IS or TIA or that it has a role in carotid plaque destabilization.

OBJETIVO: Investigar a possível relação entre Chlamydia pneumoniae e acidente vascular cerebral aterotrombótico (AVC). MÉTODO: 150 pacientes com aterotrombose carotídea foram estudados. A casuística foi dividida em 3 grupos: AVC: 65 pacientes; ataque isquêmico transitório (AIT): 26 pacientes e controles: 59. O início do AVC ou AIT era até 30 dias da inclusão no estudo. A ateromatose carotídea foi diagnosticada por ultrassonografia com Doppler. Os pacientes com risco cárdio-embólico ou sem evidência de aterotrombose foram excluídos. Foram estabelecidas comparações entre os 3 grupos e dentro de cada grupo, formado sub-grupos de acordo com diferentes idades, território arterial comprometido e fatores de risco. A detecção da bactéria foi feita por reação de polimerização em cadeia. RESULTADOS: Somente um paciente, pertencente ao grupo controle, teve resultado positivo. CONCLUSÃO: Estes achados não sugerem que a C. pneumoniae participe no desencadeamento do AVC ou AIT ou que tenha papel na desestabilização da placa.

Chronic Chlamydia pneumoniae infection and bronchial asthma: is there a link?

PURPOSE: Besides well-defined environmental causes, accumulating evidence suggests that respiratory tract infections play an important role in the pathogenesis of asthma. Among these Chlamydia pneumoniae infection has been discussed as possibly inducing the development of asthma. METHODS: This study was designed to investigate the presence of anti chlamydial IgG, IgA, and IgM antibodies by ELISA in serum samples of 60 adults with a clinical history of asthma and 100 healthy age and sex matched controls. All the samples positive for Chlamydial genus specific IgG antibodies were then subjected to Chlamydia pneumoniae species specific IgG antibody ELISA. RESULTS: The IgG anti chlamydial antibody-positivity rate in the patients with bronchial asthma (80%) was significantly higher in all age groups than that in the healthy age and sex matched controls (59%). No significant association was observed for IgA and IgM anti chlamydial antibodies. C. pneumoniae species specific IgG antibody seroprevalence was also found to be significantly higher in all age groups in comparison to controls (61.66% vs 38%). CONCLUSIONS: Serological evidence of chronic infection with C. pneumoniae was more frequent in patients with asthma compared with control subjects. Our results support the correlation of bronchial asthma and chronic infection with C. pneumoniae in Indian population.

A study on immunopathogenetic mechanisms of atherosclerotic process caused by chronic infection of Chlamydia pneumoniae in rats (Ratus novergicus).

AIM: this study was aimed to determine the correlations between duration of Chlamydia pneumoniae infection and the development of atherosclerotic process in white-rats' (Ratus novergicus) aorta. METHODS: this is an experimental study which examined the expression of TNFa, IL-1b, IL-8, adhesion molecule of VCAM-1 and the development of foam cells associated with atherosclerotic process in white-rats' aorta. There were 32 male rats, +/- 6 weeks of age, divided into 4 groups: control group (K) without infection, and 3 groups with infection through nasal and oral inoculation of Chlamydia pneumoniae by single dose of 5 x 105 in amount of 35 microl. The first group (P1) was preserved for 5(1/2) months period, the second group (P2) was preserved for 7(1/2) months and the third group (P3) was preserved for 9(1/2) months. At the end of study, histological slides were made from aortic tissues in order to study the development of atherosclerotic process by examining foam cells and cytokines expression of TNFa, IL-1b, IL-8 and VCAM-1. Foam cells examination was performed by Hematoxcillin-eosin staining, while indirect immunohistochemistry staining was used to examine the expression of TNFa, IL-1b, IL-8 and VCAM-1. Afterward, the amount of foam cells and cytokines expression was measured. The study result was analyzed by ANOVA. RESULTS: there was increased expression of TNFa, IL-1b, IL-8, VCAM-1and increased foam cells formation (extended atherosclerosis area) in the aortic tissues infected by Chlamydia pneumoniae (5(1/2) months, 7(1/2) months and 9(1/2) months), which was significantly different compared to the control group. The result of ANOVA revealed that the most important factor in tissue injury is foam cells development induced by VCAM-1 and IL-8 in all of phases (characterized by most abundant neutrophil infiltration). It indicated the infection caused by extracellular pathogenic agent, which established the fatty streak (acute phase) in 5(1/2) months period. In the group with 7(1/2) months infection period, TNFa also had important roles (characterized by increased monocytes and lymphocytes infiltration), indicating that there was negative-gram pathogenic agent with intracellular infection, which caused a progressive atherosclerotic process, and development of fibrosis / atherosclerotic plaque (sub acute phase). In 9(1/2) months infection period, there was large thrombus containing a lot of leukocytes in the aorta (chronic phase). CONCLUSION: based on the result of this study, it may be concluded that Chlamydia pneumoniae may cause atherosclerotic process in aorta. Extracellular infection of Chlamydia pneumoniae occurs in all of phases and intracellular infection begins in sub-acute phase. On 5(1/2) months period, fatty streak is developed (acute phase); on 7(1/2) months period, there is atherosclerotic plaque (sub acute phase); and on 9(1/2) period, there is large thrombus containing a lot of leukocytes (a progressive chronic phase).

Chlamydophila (Chlamydia) pneumoniae as a cause of community-acquired pneumonia in Thailand.

Chlamydophila (Chlamydia) pneumoniae infection is increasingly reported worldwide nowadays. We studied twelve Thai adults presenting with the clinical symptoms and signs of community-acquired pneumonia (CAP) due to C. pneumoniae (TWAR) at Pramongkutklao Hospital in Bangkok, Thailand. Their mean age was 38 (range 21-73) years. Six patients lived in Bangkok. Seven patients had comorbid diseases (four cases with allergic asthma, one each with diabetes mellitus, chronic obstructive pulmonary disease and coronary artery disease). C. pneumoniae pneumonia presented as subacute pneumonia in 6 patients. The clinical manifestations were mild (IDSA risk class I-III) except in 4 patients who had preexisting allergic asthma, COPD and coronary heart disease. The diagnosis of C. pneumoniae pneumonia was based on microimmunofluorescence (MIF) antibody technique (IgM titer > or = 1:16, IgG > or = 1:512, IgA > or = 1:256 with or without fourfold rises). The clinical conditions were consistent with the primary infection (IgM titer of 1:16 or higher) in 6 patients and reinfection (IgG titer of 1:512, IgA titer of 1:256 or higher without rises of IgM titer) in the other 6 patients. Minimal bilateral pleural effusion was detected in only one patient. Coinfection was demonstrated in 2 patients (one each with S. pneumoniae and K. pneumoniae). All patients markedly improved after a 2-week course of macrolide, doxycycline or newest fluoroquinolone therapy. All patients had done well at one year of follow-up. C. pneumoniae infection has been recently recognized and a high seroprevalence (37%) in Thai school children and 100 per cent in young male Thai military conscripts has been reported. This report suggests that this infection, C. pneumoniae, may be a common pathogen of CAP in Thailand.