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[The diagnostic and therapeutic problems in genital infections caused by Chlamydia trachomatis].

There have been examined 28 married couples from 25 to 35 years old with fertility and 55 patients from 25 to 40 years old with symptoms of genital infection and promiscuity. Chlamydia-antigens in urethral and endocervical specimens and antibodies in blood were searched by the Microimmunofluorescence method. Only 7.1% of the married couples and 1.8% of the patients had positive results for antigens. 53.6% of the married couples and 54.25 of the patients had positive results for antibodies, at rates from 1:32 to 1:512, confirming a profound Chlamydia trachomatis-genital infection. Outline laboratory analysis are needed for solving the diagnostic and therapeutic problems of Chlamydia trachomatis-genital infections.

Adult↗

Distinct homing pathways direct T lymphocytes to the genital and intestinal mucosae in Chlamydia-infected mice.

Immunity to genital tract infection with Chlamydia trachomatis is mediated by type 1 CD4+ T lymphocytes. To define the signals that govern lymphocyte trafficking to the genital mucosa, integrins expressed by infiltrating T cells and endothelial addressins displayed on local vasculature were characterized during the course of infection. All T cells expressed the alphaLbeta2 heterodimer that binds vascular ICAM-1, and most displayed enhanced levels of the alpha4beta1 integrin that interacts with VCAM-1. AlphaE and beta7(low) integrin chains were detected on approximately 15 and 30% of infiltrating T cells, respectively. Lymphocytes derived from the spleen or draining lymph nodes expressed this same integrin profile, suggesting that cells are recruited to the genital mucosa from the systemic circulation without significant selection pressure for these markers. Immunofluorescent staining for the corresponding vascular addressins revealed intense expression of VCAM-1 on small vessels within Chlamydia-infected genital tracts and up-regulation of ICAM-1 on endothelial, stromal, and epithelial cells. Mucosal addressin cell adhesion molecule-1 was not detected within genital tissues. These results indicate that T lymphocyte homing to the genital mucosa requires the interaction of alphaLbeta2 and alpha4beta1 with endothelial ICAM-1 and VCAM-1, respectively, which is the same pathway that directs lymphocytes to systemic sites of inflammation. Homing pathways defined for the intestinal mucosa and assumed to be relevant to all mucosal sites are not well represented in the genital tract. The identification of T lymphocyte trafficking pathways shared between systemic and mucosal tissues should facilitate vaccine strategies aimed at maximizing immune responses against Chlamydia and other pathogens of the urogenital tract.

Animals↗

[A comparative study of the information value of the immunofluorescence and immunochromatographic identification of Chlamydia trachomatis antigens in smear material from the cervical canal and of the cytological picture of a vaginal discharge in pregnant women].

The cytological picture of the vaginal discharge and scrape material, obtained from 30 pregnant women of the control group (not infected with C.trachomatis) and 61 pregnant women with chlamydiosis; of these, in 42 women the comparative identification of chlamydiae by the methods of direct immunofluorescence and immunochromatography was carried out. Direct immunofluorescence was carried out with the use of a set of reagents "MicroTrak" (USA) and immunochromatographic identification was made with the use of a set of reagents "Clearview Chlamydia" (Britain). The comparison of the results of immunochromatography and direct immunofluorescence revealed that the sensitivity of the set "Clearview Chlamydia" was 100.0% in comparison with the data obtained in the examination of women with the use of the set "MicroTrak". The negative results coincided in 90.1% of cases. The common features of the cytological picture of vaginal samples taken from pregnant women were established. The optimum system of the examination of pregnant women suspected for chlamydiosis, as well as for the evaluation of the effectiveness of its treatment, was proposed.

Antigens, Bacterial↗

Synovial Chlamydia trachomatis in patients with reactive arthritis/Reiter's syndrome are viable but show aberrant gene expression.

OBJECTIVE: We used reverse transcription-polymerase chain reaction (RT-PCR) assays to assess expression of genes from Chlamydia trachomatis in synovial tissues of patients with reactive arthritis (ReA)/Reiter's syndrome (RS) to determine viability/metabolic activity of the bacterium in joints of infected patients. METHODS: Synovial biopsies were obtained from 18 patients with ReA, RS, or other arthritides; nucleic acids from 16 samples were PCR positive for chlamydial chromosomal DNA. RT-PCR assays targeting primary transcripts from C. trachomatis rRNA operons, and mRNA from the bacterial omp1, hsp60, glyQS, and r-protein S5 and L5 genes, were used to characterize viability/metabolic activity. Host actin mRNA was assessed as control in each sample preparation. RESULTS: RT-PCR of host cell actin mRNA in the 18 patient samples confirmed the quality of all RNA preparations. RNA from 14/16 PCR positive samples was positive by RT-PCR for chlamydial rRNA primary transcripts. Each of these same 14 samples was also RT-PCR positive in assays targeting glyQS, r-protein S5 and L5, and hsp60 mRNA. However, none of the 14 samples showing chlamydial rRNA and mRNA was positive for omp1 transcripts. CONCLUSION: Synovial chlamydia are viable/metabolically active, since primary rRNA transcripts and mRNA from chlamydial genes specifying components of the bacterial protein synthetic system were present in most patient samples assayed. Expression of omp1, encoding the major outer membrane protein, is strongly attenuated in persistently infecting synovial chlamydia, while that of hsp60, specifying a highly immunogenic heat shock protein of the organism, is not downregulated.

Adult↗

[Pathogenetic aspects of chlamydia-associated urogenic arthritis: feasibility of microorganism reproduction in cells of articular cartilage].

AIM: The study of feasibility of Chlamydia trachomatis infection and reproduction. This microorganism is an essential etiologic factor in urogenic arthritis, in chondrocytes and fibroblasts of human skin. MATERIALS AND METHODS: Infection of human skin chondrocytes and fibroblasts was made with chlamydia CP-1 strain isolated from joint fluid of the patient and serially passaged in the hen's embryo yolksacs. The inoculation results were assessed by direct staining with the use of monoclonal and fluorescent antibodies and hematoxiline. RESULTS: Chlamydial infection of human skin connective tissue, chondrocytes of the auricular cartilage and fibroblasts in particular, is possible. CONCLUSION: The findings confirm the ability of Chlamydia trachomatis to reproduce in the cartilage tissue.

Adult↗

[Chlamydia trachomatis and its role in female infertility].

Infertility is a worldwide problem. 15-20% married couples are childless though they want children. The tubal factor is the most frequent cause of female infertility. Chlamydia trachomatis is one of the most frequent pathogenic organisms which cause tubal occlusion. From January 1995 till June 1997 at the 1st Dept. Gynecol. and Obstetric, 1st Fac. of Medicine 327 infertile women were examined divided into three groups (sterile, included in the IVF programme on account of the tubal factor and those included in the programme for other reasons). In all an antigenic examination from the endocervix and serological examination of antichlamydia antibodies was made. In 73 women in the IVF programme by microabrasion of the endometrium material for detection of Chlamydia infection was obtained by PCR. During sampling from the uterine cervix the appearance of the portio uteri, discharge, haemorrhage and pain on examination were evaluated. For statistical evaluation the chi square test was used. In 61% patients anamnestic IGG antibodies were detected suggesting a past or present Chlamydia infection. In women included in the IVF programme on account of the tubal factor there was a significantly higher IgG positivity (92%). Of ten women who suffered from acute chlamydial cervicitis only in one the infection was detected during microabrasion of the endometrium. 65% antigen positive patients had complaints during the examination (discharge, bleeding, pain). The authors discuss the impact of the assembled results from the aspect of impaired fertility of women in the Czech Republic.

Adult↗

[Role of chlamydia in chronic renal and urogenital diseases in man].

Serological examinations by the CFT with the group-specific ornithosis antigen were carried out with 1910 sera from patients with chronic diseases of the kidneys, urinary tracts and male sexual organs, as well as with 556 control sera from patients with cardio-vascular and other diseases for elucidation of the role of chlamydia (OLT group) in the infectious pathology of the kidneys and urinary tracts of man. No complement-fixing antibody was detected with the group-specific ornithosis antigen in control sera. The antibody was found in 5.2% of sera from patients with chronic diseases of the kidneys and upper urinary tracts and in 6.2% of cases with the involvement of the proximal part of the urinary tracts and male sexual organs. The intradermal test (IDT) with ornithosis allergen was performed for those patients whose sera contained complement-fixing antibody. The results of CFT and IDT coincided in 82.8% of the patients, thus confirming the etiological role of chlamydia in human urogenital pathology. Studies on the positive sera with the species-specific ornithosis antigen gave negative results, indicating that a distinct species of chlamydia is the agent of urogenital diseases.

Adolescent↗

Prevalence of Chlamydia trachomatis cervical infection in female adolescents.

To determine the prevalence of infection with Chlamydia trachomatis in young girls with the same socioeconomic background from New York City, 186 sexually active female adolescents (age range, 12 to 17 years; mean age, 15.5 years) were screened. One third of the patients were pregnant. Papanicolaou smears, endocervical cultures for C trachomatis and Neisseria gonorrhoeae, and syphilis serologic tests were obtained prospectively. Chlamydia trachomatis was isolated from 10.2% of the subjects, and N gonorrhoeae was isolated from 9.7% of the subjects; 3.2% of the subjects had syphilis. At least one sexually transmitted disease was found in 17.2% of the subjects. Eight (44%) of 18 patients with N gonorrhoeae also harbored Chlamydia. The high rate of multiple infection should have significant implications with regard to treatment. High isolation rates of C trachomatis and other sexually transmitted pathogens suggested that routine screening may be warranted in even the very young, sexually active female adolescent, and especially in pregnant girls.

Adolescent↗

Effects of interferon gamma on Chlamydia trachomatis serovar A and L2 protein expression investigated by two-dimensional gel electrophoresis.

Chlamydia trachomatis is an obligate intracellular bacterium causing human ocular and genital disease. The lymphokine interferon gamma (IFN-gamma) is an important immune effector exerting antimicrobial effects towards several intracellular parasites, the chlamydia included. IFN-gamma has been reported to inhibit the chlamydial replication in vitro in part by depleting intracellular levels of tryptophan in a dose-dependent manner. In addition, down-regulation of important immunogens has been described. These findings are extended in this paper, in which we are combining pulse labeling with [35S]methionine and two-dimensional gel electrophoresis with immobilized pH gradients in order to investigate changes in the protein expression of C. trachomatis serovar A and L2 caused by treatment with IFN-gamma. In contrast to what was observed in C. trachomatis L2, our results showed that, in C. trachomatis A, down-regulations of the chlamydia major outer membrane protein and of several other proteins were detectable upon IFN-gamma treatment. In addition, we report the up-regulations of C. trachomatis A and L2 proteins with molecular masses of approximately 30 kDa and 40 kDa which may be part of an, as yet, uncharacterized chlamydial response to IFN-gamma treatment.

Antibodies, Monoclonal↗

Interaction of chlamydiae with host cells and mucous surfaces.

For chlamydiae, as obligate intracellular parasites, attachment to and ingestion by host cells are essential steps in reproduction. Their attachment site appears to be heat-sensitive; it has not been correlated with any morphological entity. Antibody blocks chlamydial attachment to cells and, for certain chlamydia psittaci and chlamydia trachomatis strains which are highly infective for cell cultures, N-acetylglucosamine appears to contribute to cell receptor specificity. Sialic acid residues have been suggested as receptors for other C. trachomatis strains. The guinea-pig inclusion conjunctivitis strain of C. psittaci becomes associated with the conjunctiva during incubation of inoculated tissue fragments in vitro. However, although antibody from tears neutralizes infectivity of this strain in vivo, association of the organism with tissue fragments is not inhibited, suggesting that antibody neutralization in vivo is not mediated by prevention of attachment to cells. Chlamydial infectivity for cell monolayers is greatly increased by centrifugation. The process is temperature-dependent and involves cooperative interactions between direction force and the pressure generated during centrifugation. Enhanced infectivity appears to result from changes induced in the cell surface. These changes may favour nonspecific interactions in attachment, since antibody inhibition of infectivity on static cell monolayers is overcome by centrifugation.

Acetylglucosamine↗

Seropositivity against Chlamydia pneumoniae in patients with coronary atherosclerosis.

BACKGROUND: Results of therapy in patients with unstable coronary syndromes with antibiotics directed against Chlamydia pneumoniae have been variable, perhaps due to the heterogeneity of patients in these trials. HYPOTHESIS: The aim of the present study was to correlate the severity of coronary artery disease (CAD) with seropositivity against C. pneumoniae prospectively. METHODS: We measured the frequency of seropositivity (IgG levels > or = 1/64 and IgA levels > or = 1/16 against Chlamydia pneumoniae) in 110 patients with CAD and in 49 controls. RESULTS: As expected, traditional CAD risk factors were seen more often in patients with CAD than in controls. Mean values of total cholesterol (184 +/- 52 and 166 +/- 44 mg/dl, respectively) and triglyceride (143 +/- 60 and 112 +/- 63 mg/dl, respectively) in serum were significantly higher in patients with CAD than in controls (both p < 0.04). There were no significant differences between the two groups in serum high-density lipoprotein cholesterol (34 +/- 13 and 32 +/- 14 mg/dl, respectively) and lipoprotein (a) (Lp(a):241 +/- 247 and 223 +/- 263 mg/l, respectively) levels. The rate of IgG seropositivity was 52% (28/54) in patients with stable CAD, 41% (23/56) in patients with unstable CAD, and 35% in controls (p = NS). The rate of IgA seropositivity was 25% (14/54) in patients with stable CAD, 12% (6/49) in patients with unstable angina, and 12% (6/49) in controls (all p = NS). CONCLUSIONS: Only a small percentage of patients with CAD demonstrate seropositivity against Chlamydia pneumoniae. Antibiotic therapy in these selected patients, but not in the remaining patients, may be considered rational. These considerations may underlie the failure to see consistent benefits of antibiotic therapy in patients with CAD.

Analysis of Variance↗

Binding, ingestion, and growth of Chlamydia trachomatis (L2 serovar) analyzed by flow cytometry.

We have developed a method for quantitatively assessing binding, ingestion, and growth of Chlamydia trachomatis (L2 serovar) in several mammalian cell lines using fluorescence staining and flow cytometry. Cells were incubated with chlamydia at 4 degrees C to monitor binding; ingestion was determined by raising the temperature to 37 degrees C for 1-4 h and removing extracellular bacteria with pronase. Growth of bacteria was measured by assessing brightly stained intracellular inclusions. Fixation with methanol prior to fluorescent staining provided the most intense specific staining with minimal background, as well as preserving cell morphology. Our data reveal relatively slow ingestion of L2 by McCoy fibroblasts (maximum ingestion by 4 h) and a sizeable population of McCoy cells (30-40% of total cells) that ingest L2 but do not permit its growth under certain infectious conditions. It was possible to correlate specific histogram patterns on the flow cytometer with fluorescent microscope observations. This system provides a means of analyzing quantitative interactions between chlamydia and individual host cells.

Animals↗

Asymptomatic chlamydia during pregnancy.

Data were collected by certified nurse midwives during routine antepartum visits for 111 low-income women. There was a significant difference between the incidence of chlamydia n = 25 (22.5%) and gonorrhea n = 2 (1.8%), Z-score = 4.7; p less than .01. If current practices for selective screening were used 19 of the 25 women who had a positive chlamydia would not have been tested. Given the complications associated with chlamydia for women and their offspring, early detection, treatment, and education programs are justified.

Black or African American↗

Growth of Chlamydia pneumoniae in cultured human peripheral blood mononuclear cells and induction of a cytokine response.

In vitro infection of freshly isolated human peripheral blood mononuclear cells (HPBMC) with Chlamydia pneumoniae was found to induce a production of tumour necrosis factor alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6) and interferon alpha (IFN-alpha). The secretion was dependent on the amount of infecting chlamydiae and most of it occurred during the first 12 to 24 h. Lipopolysaccharide (LPS) of Salmonella minnesota Rechemotype, used as a positive control for HPBMC activation, induced a release of TNF-alpha, IL-1 beta and IL-6, but not of IFN-alpha, similar to the effect of C. pneumoniae. Viable chlamydiae could not be recovered from HPBMCs infected immediately after their isolation, whereas HPBMCs which were cultured in vitro for 3 to 9 days before infection were able to maintain the growth of C. pneumoniae. Growth inside HPBMCs as well as induction of cytokine response may have a role in the pathogenesis of C. pneumoniae infection.

Chlamydia Infections↗

Chlamydia trachomatis-induced apoptosis occurs in uninfected McCoy cells late in the developmental cycle and is regulated by the intracellular redox state.

Infections with the obligate intracellular bacterium Chlamydia trachomatis are characterized by avoidance of fusion between chlamydia-containing endosomes and lysosomes, bacterial persistence and development of post-infectious sequelae. In this report we show that C. trachomatis induces apoptosis in McCoy and HeLa cells. Apoptosis was monitored by three different techniques; enzyme-linked immunoassay (EIA) of fragmented nucleosomes, terminal deoxynucleotidyl transferase-mediated dUTP nick end labelling (TUNEL) and flow cytometry of propidium iodide-stained cells. Apoptosis occurred in uninfected cells, was induced late in the chlamydial developmental cycle, beyond 24 h post-infection and was dependent on bacterial protein synthesis. Apoptosis was not significantly increased in infected, inclusion-containing cells. Treatment of cells with the antioxidants ascorbic acid (10 microM) and alpha-tocopherol (10 microM) reduced the degree of apoptosis. These results suggest that host cells infected with C. trachomatis generate proapoptotic stimuli that induce apoptosis in uninfected, neighbouring cells and that the redox state of the cell is a regulator in chlamydia-induced apoptosis.

Animals↗

Chlamydia specific IgG and IgA antibodies in women with obstructive infertility as determined by immunoblotting and immunoperoxidase assays.

The prevalence rate of IgG and IgA antibodies to Chlamydia was analyzed in 50 women with laparoscopy-verified tubal infertility and in 50 age-matched control women by single serovar (L2) inclusion immunoperoxidase assay (IPA) and by immunoblotting technique (IB). Women with tubal infertility had significantly (p less than 0.001) elevated IPA Chlamydia IgG antibody titer greater than or equal to 128 and greater than or equal to 256 than controls (64% vs 16%. Odds ratios = 9.3 and 50% vs 10%, Odds ratio = 9 respectively). The prevalence rate of IPA IgA antibody titer (greater than or equal to 16) to Chlamydia was also significantly higher (p less than 0.001) in women with tubal infertility than controls (48% vs 8%, Odds ratio = 10.6). Antibodies to at least 19 chlamydial structural polypeptides ranging in molecular weight from 30 kD to 204 kD, were detected by the IB technique in the IPA seropositive sera. Antibodies to 57-60 kD were detectable in almost all the IPA IgG and IgA seropositive sera. The prevalence rate of IgG antibody to 57 kD-60 kD was significantly higher in women with obstructive infertility than healthy woman (84% vs. 56% p less than 0.01; Odds ratio = 3.8). More significantly, higher differences to 57-60 kD polypeptide were found in the case of IgA between the infertile women and controls (52% vs. 10%, p less than 0.001; Odds ratio = 9.7). The significance of IPA and IB technique for screening of infertile women is discussed.

Adult↗

Detection of circulating antigens of Chlamydia trachomatis by counterimmunoelectrophoresis.

An increasing number of reports on Chlamydia trachomatis pneumonia in infancy has recently been published in the literature. The demonstration of the etiologic agent depends, however, on laborious culture procedures and serological techniques. Based on the observation of a cross-reaction between certain Acinetobacter species and chlamydiae, the detection of chlamydial antigens in sera of 5 infants with distinctive clinical features of a pneumonia due to Chlamydia trachomatis was performed with antisera to Acinetobacter by the counterimmunoelectrophoresis (CIE) technique.

Acinetobacter↗

Detection of infections of the eye with Chlamydia trachomatis by the polymerase chain reaction.

The aim of this study was to test the diagnostic feasibility of the polymerase chain reaction (PCR) for detection of infections with Chlamydia trachomatis in eye swabs from patients with conjunctivitis, and to establish the basic technique of the PCR for epidemiological survey. The results of the PCR were compared with the Mikro Trak immunofluorescence assay (IFA). From 49 specimens of patients with conjunctivitis, 31 were found positive by PCR (63%) and 23 by IFA (47%). On the other hand, in 10 normal eye specimens and 10 non-Chlamydia trachoma conjunctivitis specimens no Chlamydia trachomatis was detected.

Antibodies, Bacterial↗