The presence of Chlamydia trachomatis infection in men with chronic prostatitis.

INTRODUCTION: The aim of the study was to evaluate the frequency of occurrence of Chlamydia trachomatis (C.t.) DNA in the prostate material in the group of individuals with the chronic prostatitis. MATERIAL AND METHODS: The study included 65 males aged between 47 and 68 years of age, reporting for transrectal prostate biopsy because of the elevated serum prostate-specific antigen concentration and/or abnormalities detected in prostate palpation per rectum. The urethral smear collection was performed in all the patients in order to detect C.t. DNA. After that, the transrectal prostate biopsy was performed (histopathology tests, C.t. DNA). Additionally, the levels of anti-C.t. IgG antibodies and anti-C.t. IgA antibodies were checked in the serum. The DNA isolation from prostate specimens was conducted with the use of the Chelex method, while the C.t. DNA detection - with the ligase chain reaction. Specific antibodies were detected with the use of the ELISA method. RESULTS: C.t. DNA in the prostate gland was found in 7 out of 65 men (10.8%). In urethral smear, C.t. was found in none of the individuals. Anti-C.t. IgA antibodies were detected in the serum of 16/65 (24.6%), while anti-C.t. IgG antibodies in 6/65 (9.2%) of the examined males. IgA antibodies were found in two and IgG in one out of the 7 men who had C.t. infection in the prostate. CONCLUSIONS: The presence of C.t. DNA in the prostate gland may be indicative of the role of chlamydia in the development of chronic prostatitis.

Incidence of Chlamydia trachomatis infection in patients with reactive arthritis.

OBJECTIVES: The aim of the study was to evaluate the incidence of Chlamydia trachomatis in patients with reactive arthritis (ReA) within the area of the Podlaskie province (north eastern Poland). MATERIAL AND METHODS: The study concerned 323 patients including 132 women and 191 men diagnosed with ReA. The material for C. trachomatis was collected from the urethra in men and the cervical canal in women. Also, every patient was tested for the presence of anti-C. trachomatis IgG class antibodies, while 121 individuals were additionally tested for IgA class antibodies. In the direct studies, the direct immunofluorescence (DIF) method or polymerase chain reaction (PCR) was used. The immunoenzymatic method was used to detect anti-C. trachomatis antibodies. The control group in the case of direct studies comprised 125 individuals, while in the case of serology research it included 127 (IgG) and 109 (IgA) persons. RESULTS: Chlamydia trachomatis infection in the urethral and cervical smears was found in 42 patients (13.0%) including 20 women (15.2%) and 22 men (11.5%). In the control group chlamydia was detected in 3 patients (2.4%) including 4% of women and 2% of men. IgA class antibodies were present in 10/121 (8.3%) patients, similarly in women and in men (8.2% and 8.3% respectively). In the control group the specific IgA class antibodies were found in 3/85 patients (3.5%). Anti-C. trachomatis IgG antibodies were found in 70/323 patients (21.7%), similarly in men and women. CONCLUSIONS: Chlamydia trachomatis is a common bacterial factor observed in the genitourinary system of patients with ReA. The outcomes of studies within the Podlaskie province indicate less frequent presence of chlamydial infection compared with Dolnoslaskie province.No correlations between detecting the presence of C. trachomatis in the urogenital tract and the presence of specific antibodies in the serum of ReA patients were observed.Concurrent direct studies of the urogenital tract and a serological blood test increase the chance of detecting C. trachomatis infection.

The evaluation of markers of prostatic inflammation and function of the prostate gland in patients with chronic prostatitis.

INTRODUCTION: The aim of the study was to determine the numbers of polymorphonuclear (PMN) leukocytes and PMN elastase and citric acid concentrations in chronic prostatitis patients regardless of etiology and in those with Chlamydia trachomatis infection of the prostate gland. MATERIALS AND METHODS: The study involved 46 patients with chronic prostatitis. Expressed prostatic secretions (EPS) were obtained to determine the leukocyte count, PMN elastase (ELISA) and citric acid concentrations (UV method), and the occurrence of C. trachomatis infection (ligase chain reaction). RESULTS: Increased PMN cell counts (> or =10 per high-power field) were found in 73.9% of patients and increased PMN elastase concentration (<250 ng/ml) in 78.3%. In 44.4% of the patients the elastase concentration indicated moderate (250-1000 ng/ml) and in 55.6% acute infection (> or =1000 ng/ml). Decreased citric acid concentration (<18.12 mg/ml) in the EPS was found in 65.2% of the men. C. trachomatis prostate infection was detected in 17.4% of the patients and all of these men had higher inflammation parameters and lower citric acid concentrations. CONCLUSIONS: C. trachomatis prostate inflammation was accompanied by an increase in inflammation markers and a decrease in citric acid concentration.

Antichlamydial antibodies and citric acid in patients with chronic prostatitis.

INTRODUCTION: The aim of the study was to evaluate the correlation between the presence of anti-C. trachomatis (C.t.) antibodies in serum and expressed prostatic secretions (EPS) and the concentration of citric acid in patients with chronic prostatitis. MATERIALS AND METHODS: The study involved 34 men with chronic prostatitis. The leukocyte count, presence of anti-C.t. antibodies (IgA, IgG), and citric acid concentration were determined in the EPS. The serum was examined for IgM, IgA, and IgG anti-C.t. antibodies. Specific antibodies were determined using the EIA method. The concentration of citric acid was measured using the ultraviolet method. RESULTS: Inflammation of the prostate (210 PMN) was found in 61.8% of the patients. A reduction in citric acid concentration in the EPS was detected in 58.8% of the men. Specific serum antibodies were detected in 58.8% of the patients, including 23.5% with IgM, 32.4% with IgA, and 44.1% with IgG. In all patients, serum IgM and IgA antibody titers were low, while those of IgG antibodies were strongly positive in 46.7% of the patients. Anti-C.t. antibodies in the EPS were detected in 44.1% of the patients, including 32.4% with IgA and 35.3% with IgG. In contrast to serum, the titers of IgG antibodies in the EPS were low in all the patients, while those of IgA were strongly positive in 54.5% of cases. In patients with positive serological outcomes, 85% had reduced concentrations of citric acid. CONCLUSIONS: The occurrence of anti-C.t. antibodies is usually accompanied by a decrease in the concentration of citric acid in the prostatic secretion.

The effect of Chlamydia trachomatis infection of the prostate gland on the concentration of citric acid.

INTRODUCTION: The objective of the study was to assess the relationship between Chlamydia trachomatis (C.t.) infection of the prostate and the concentration of citric acid. MATERIALS AND METHODS: The study involved 60 patients with chronic prostatitis (NIH III). Urethral swabs and expressed prostatic secretions (EPS) were collected for analysis. The urethral swabs were tested for PMNs and the presence of Neisseria gonorrhoeae and C.t., while the EPS were analyzed to determine PMN count, C.t., and citric acid concentration. The DFA or LCR method was used for C.t. diagnosis. The concentration of citric acid was measured using the UV method. RESULTS: Inflammation of the prostate (PMNs >/=10/field) was diagnosed in 58.3 of the patients. C.t. infection was found in 20%, including 8.3% with only the urethra affected and 10% with only the prostate. One patient had both the urethra and the prostate infected. A reduction in the concentration of citric acid in EPS was observed in 56.7% of the men. In 88.2% of the patients, reduced citric acid concentration was accompanied by an elevated PMN count in the EPS. All patients with C.t. infection of the prostate showed a reduced concentration of citric acid. In five patients with urethral infection, lack of a decrease in this parameter was noted in one. In all the patients with chlamydial infection, irrespective of localization, a high PMN count was observed in the EPS. CONCLUSIONS: Determination of the concentration of citric acid in the prostatic fluid is a good indicator of prostatitis. C.t. infection of the prostate gland is accompanied by a decrease in the concentration of citric acid.

[Drug hypersensitivity syndrome]. / Drug hypersensitivity syndrome--odczyn polekowy z objawami ukladowymi.

The drug hypersensitivity syndrome (DHS) is a drug-induced reaction of an extremely severe clinical course and serious prognosis. It poses major diagnostic problems and is frequently unrecognized by clinicians. Based on literature data, the authors have presented the information on epidemiology, etiology, pathogenesis, clinical picture, diagnostics and treatment of DHS. This is the first report in Poland concerning this clinical interdisciplinary syndrome.

Chlamydia trachomatis infections in women with adverse pregnancy outcome.

AIM: The aim of the study was to evaluate the prevalence of Chlamydia trachomatis (C. trachomatis) infection in women with adverse pregnancy outcomes. MATERIAL AND METHOD: 258 patients aged 18-43 yrs were enrolled into the study. Among them, 162 women have had spontaneous abortions in the past (group A), 81 had history of intrauterine death of the foetus (group B) and 15 women had experienced preterm deliveries (group C). The control group (group D) included 131 women who were in the second or third trimester of uncomplicated pregnancy. C. trachomatis was investigated in cervical and urethral smears using direct immunofluorescence or Ligase chain reaction (LCR) for direct testing and immunoenzymatic assay (EIA) for serological testing and detection of specific IgG antibodies. RESULTS: C. trachomatis was detected in 25.9% patients in group A, 35.8% in group B and 20% in group C and only in 12.7% in group D. IgG specific antibodies were present in 31.5%, 41.9%, 26.6% and 14.5% of patients in these groups respectively. The highest prevalence of chlamydial infections, regardless the diagnostic method used, was registered in the group of women with a history of 3 abortions (42.3% when direct testing and 45.5% when serological testing) while the lowest prevalence was in women who experienced only l abortion (23.2% and 28%). CONCLUSION: C. trachomatis infection in pregnancy affects its duration as it can lead to miscarriage, death of the foetus and preterm delivery.

Role of Chlamydia trachomatis in male urogenital infections and its complications.

Based on a literature review, the authors present data on the epidemiology, pathogenesis, clinical picture, diagnostics and treatment of Chlamydia trachomatis urogenital infections and its complications in males.

Chlamydia trachomatis infections in children.

Based of literature data, the authors present informations on epidemiology, pathogenesis, clinical picture, diagnostics and treatment of Chlamydia trachomatis urogenital infections in children.

Subclinical prostatic inflammation attributable to Chlamydia trachomatis in a patient with prostate cancer.

Chronic inflammation has long been linked to cancers with an infectious etiology. Subclinical intraprostatic inflammation is a frequent finding in prostatic specimens obtained during surgical procedures. Recent studies using biomolecular (amplification) methods showed that the incidence of cryptic bacterial infections of prostate gland may be underestimated. We present the case of 66 years old man with no symptoms of prostatitis in whom chronic Chlamydia trachomatis infection was diagnosed based on the patient's medical history and detection of chlamydial DNA in prostate biopsy specimen by means of ligase chain reaction. Two years later the patient was diagnosed with prostate cancer on repeated prostate biopsy.

[Antiphospholipid syndrome]. / Zespól antyfosfolipidowy.

The antiphospholipid syndrome is considered to be one of the most common autoimmunological diseases. This paper is a review of contemporary literature data concerning pathogenesis and clinical and laboratory diagnostic criteria. Wide clinical symptomatology of the syndrome, differential diagnosis as well as diagnostic, therapeutic and preventive regimens are presented.

[Role of mycoplasmas in urogenital tract infections and their complications]. / Rola mykoplazm w zakazeniach narzadu moczowo-plciowego i ich powiklaniach.

In the literature from recent years it is stressed the significant epidemiological and clinical role of the sexually transmitted infections caused by so called "new generation" pathogens including mycoplasmas. The paper gives a review of the current literature concerning the epidemiology, clinical presentation, diagnosis and therapy of the infections of urogenital tract caused by mycoplasmas.

[Bacterial vaginosis]. / Bakteryjne zakazenie pochwy.

Bacterial vaginosis (BV) is one of the most common lower genital tract infections among women of childbearing age. This paper is a survey of literature data concerning epidemiology, pathogenesis, clinical and laboratory diagnostic criteria of this clinical syndrome.

[Role of Chlamydia trachomatis infection in the pathology of male urogenital tract]. / Rola zakazenia Chlamydia trachomatis w patologii meskiego narzadu moczowo-plciowego.

Based on literature data, the authors have presented the informations on epidemiology, pathogenesis, clinical picture, diagnostics and treatment of Chlamydia trachomatis urogenital infections in men.

Antichlamydial antibodies in the serum and expressed prostatic secretion in prostatitis.

INTRODUCTION: The aim of the study was to evaluate the prevalence of anti-Chlamydia trachomatis (C.trachomatis) antibodies in serum and expressed prostatic secretion (EPS) in chronic prostatitis. MATERIALS AND METHODS: Thirty-six patients with chronic prostatitis were examined. The presence of C. trachomatis was determined in urethral smears and EPS. Specific antibodies were determined in the serum (IgM, IgA, IgG) and in the EPS (IgA, IgG). In the direct diagnosis of chlamydial infection, the direct immunofluorescence method and the ligase chain reaction were employed, and for the serological diagnosis, the immunoenzymatic method. RESULTS: C. trachomatis infection was detected in the urethra of 3 (8.3%) patients and in the prostatic gland of 3 (8.3%) patients; only one of these patients was found to have C. trachomatis in both the urethra and the EPS. In the control group, C. trachomatis was detected in the urethra of 1/50 (2%) of the men, but the EPS of all of them was free of C. trachomatis. Specific IgM antibodies were found in 7 (19.4%), IgA in 9 (25%), and IgG in 18 (50%) of the patients' serum, whereas IgAs were detected in 12 (33.3%) and IgGs in 13 (36.1%) of the patients' EPS. In the control group, anti-C. trachomatis antibodies of the IgG were detected in the serum of 2/35 (5.7%) of the men, whereas in the EPS neither IgA nor IgG antibodies were detected in any of these patients. CONCLUSIONS: Serological tests of the serum and EPS are useful as a complementary method in the diagnosis of chronic prostatitis.

The immunology of Chlamydia trachomatis.

Chlamydia trachomatis (C. trachomatis) is one of the most common sexually transmitted bacterial agents. What distinguishes it from other organisms is its intracellular reproductive cycle. Up to now, four antigens have been identified in the Chlamydia genus: genus-specific antigen as well as species-specific, type-specific and subspecies-specific. C. trachomatis is a powerful immunogen which stimulates the host's immunological processes. The intracellular parasitism of the bacteria is the basis for both symptomatic or asymptomatic infection as well as for chronic ones. The primary infection leads to a local inflammatory reaction due to penetration and reproduction of the bacteria in the epithelial cells and to IgA secretory antibody production. In most cases the host's reaction to the primary infection is transient and does not cause tissue damage. In the course of chronic infection or reinfection, the most important processes are those of delayed hypersensitivity, which lead to a fast and intense immunological reaction of specifically sensitized Th1 lymphocytes. This reaction leads to progressive damage of the epithelial cells and to cicatrization and fibrosis, which means irreversible complications. Interferon gamma is of special importance in the process of C. trachomatis infection. High concentrations of it inhibit the bacteria's reproductive cycle, while lower concentrations promote the development of atypical, non-contagious forms of Chlamydia of diminished metabolic activity and altered antigenicity. The chlamydial heat shock proteins are considered to be of great importance lately. Their molecular weights of 60 and 10 kDa are a powerful stimulant of immunological reactions and show significant homology (40-90%) to human and other bacterial heat shock proteins.

[Oculogenital Chlamydia trachomatis infections in adults]. / Zakazenia okulogenitalne Chlamydia trachomatis u doroslych.

The aim of the research was to determine the prevalence of C. trachomatis (C.t.) conjunctivitis and urogenital infections coexistence in adults. The study was carried out on 222 patients (109 women and 113 men) with clinical signs of conjunctivitis. Conjunctival swabs were taken from all patients for evaluation and urogenital swabs as well as blood from the patients with confirmed infection. Direct diagnostics of chlamydial infections involved IF and LCR methods while serologic diagnostics (specific IgG antibodies) used EIA and indirect IF methods. The control group for conjunctival swabs included 52 volunteers who did not have any ophthalmological symptoms while for the serological tests the control group consisted of 103 blood donors. Ocular C.t. infection was diagnosed in 42 out of 222 (18.9%) patients with conjunctivitis symptoms and in 2 out of 52 (3.8%) patients of the control group. Chlamydial conjunctivitis was mostly (70%) found in young people (18-30 yrs) and it was twice more common in women. It was usually bilateral and chronic. Urogenital C.t. infection was diagnosed in 24 out of 42 (57.1%) patients and it was more common in men (14 patients) than in women (10 patients). Only 4 out of 42 (9.5%) patients suffered from any urogenital symptoms. Specific IgG antibodies were found in the serum of 29 out of 42 (69%) patients with chlamydial conjunctivitis and only in 6 out of 103 (5.8%) patients of the control group. The diagnostics of the ocular infections, which are resistant to routine treatment, should involve the consideration of etiological role of C.t. Due to common urogenital chlamydial infection coexistence both sexual partners should be diagnosed and treated.