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PubMed2000

Chlamydia pneumoniae-associated ADEM.

Inflammatory demyelinating diseases are a common cause of neurologic disability in young adults, and usually the cause is unknown. We describe a case of acute disseminated encephalomyelitis (ADEM) associated with Chlamydia pneumoniae infection. An 18-year-old previously healthy women, with a one-week history of coryzal illness, was admitted because of progressive headache, dizziness, and a left-sided hemiparesis. MR imaging of the brain and brainstem showed typical signs of ADEM. The diagnosis was established by PCR Chlamydia pneumoniae DNA positivity in a tracheal swab and by increasing titres of Chlamydia IgM antibody. The patient was treated with doxycycline and steroids and recovered completely. Apart from therapeutic implications, this case may contribute to our understanding of demyelinating diseases of the central nervous system.

Adolescent↗
PubMed2001

Antibodies against Chlamydia pneumoniae predict the need for elective surgical intervention on small abdominal aortic aneurysms.

OBJECTIVE: to compare the ability of two independent Chlamydia pneumoniae antibody tests to predict need for small abdominal aortic aneurysm (AAA) repair. PATIENTS AND METHODS: annual scans were offered to 149 screening diagnosed small AAA (<5 cm). Serum samples were collected for measuring IgA and IgG-antibodies to C. pneumoniae by microimmunofluorescence (MIF) test and the new ELISA (Labsystems). RESULTS: a significant concordance was found between MIF and ELISA titres with Kappa values of 0.29 for S-IgA and 0.42 for S-IgG. IgG antibodies measured by ELISA were most predictive for cases expanding operation recommendable sizes with a sensitivity and specificity of 80% and 66%, respectively. CONCLUSION: the simpler EIA has a high correlation with the MIF test and both were predictive for the natural history of AAA. Chlamydia antibody test may be used to identify individuals who might benefit from follow-up and anti-chlamydia treatment.

Aged↗
PubMed2003

Chlamydia pneumoniae survival in macrophages is regulated by free Ca2+ dependent reactive nitrogen and oxygen species.

OBJECTIVES: Despite an efficient macrophage immune capability, Chlamydia pneumoniae infects host cells and causes chronic diseases. To gain better insights into C. pneumoniae survival mechanisms in macrophages, its growth in regular RAW-264.7 cells (nitric oxide sufficient NO (+)) and RAW-264.7 cells (nitric oxide insufficient NO (-)) were studied. METHODS: Role of Ca(2+), NO and reactive oxygen species (ROS) during C. pneumoniae infection in macrophages were determined. RESULTS: RAW-264.7 NO (-) cells supported significantly Chlamydia growth, showing an upregulation of ROS, superoxide dismutase (SOD) and catalase activities as compared with RAW-264.7 NO (+) cell. Ascorbic acid, inducible nitric oxide synthase inhibitor and glutathione significantly prompted Chlamydia inclusion formation. Cytosolic Ca(2+) had regulatory effect on organism growth, NO generation, SOD and catalase activities in both cell types. CONCLUSIONS: These findings suggest that minimal Ca(2+) signaling in macrophages at early stages of infection, NO and ROS release have modulatory effects onC. pneumoniae survival, onset of persistence and chronicity, processes which are needed for the initiation of diseases in which C. pneumoniae has been implicated as a possible etiologic agent.

Animals↗
PubMed1999

[Persistence of Chlamydia pneumoniae in coronary plaque tissue. A contribution to infection and immune hypothesis in unstable angina pectoris].

BACKGROUND AND OBJECTIVE: There is an increasing number of pointers towards a causative connection between Chlamydia pneumoniae and atherosclerosis. But the pathogenetic mechanism and intimal structures that are involved remain unclear. Starting with the hypothesis of a chronic infection, as demonstrated by the presence of the chlamydial stress (heat-shock) protein 60 (HSP 60), the presence and localization of these bacterial products in coronary atheromas was investigated. PATIENTS AND METHODS: Coronary atheroma tissue from primary stenoses in 42 patients (36 men, 6 women, mean age 60.2 +/- 7.3 years) was studied immunohistochemically in the course of a retrospective analysis for chlamydial HSP 60. The findings in clinically acute coronary syndrome (Braunwald's classification) present in 27 patients were compared with those in 15 patients with acute angina and evaluated in relation to expression and site of predilection. RESULTS: An immune reaction to chlamydial HSP 60 was demonstrated in 27 of 42 atheromas (64%). Intact, non-atherosclerotic vessels, such as the mammary artery and sphenous vein, showed no such signals. Chlamydial HSP 60 was localized in maximally 23% of all plaque cells, mostly in macrophages/foam cells, more rarely in smooth muscle cells. Chlamydia in foam cells most often revealed ultrastructural patterns that pointed to the persistence of the pathogen. Sites of predilection of chlamydial HSP were predominantly foam cell areas and cell-poor regions, more rarely inflammatory infiltrates and areas of rupture. When comparing both types of lesion, signals for chlamydial HSP 60 were present in 21 of the 27 atheromas (78%) with unstable angina or acute myocardial infarction, but in only 6 of the 15 atheromas (40%) with stable angina. Within the group with the acute coronary syndrome, the prevalence of chronic chlamydial infection was independent of a previous myocardial infarction. CONCLUSIONS: Chlamydial HSP 60 can often be demonstrated in primary coronary stenosis of symptomatic patients. It is most frequently found in macrophages/foam cells and is highly prevalent in the acute coronary syndrome. In-situ findings suggest a pathogenetically relevant role of chronic persistent infection of Chlamydia pneumoniae in unstable coronary plaques.

Adult↗
PubMed1994

[Isolation of Chlamydia pneumoniae in atypical pneumonia].

A 33-year-old man, who two months previously had been treated for bronchopneumonia with cefuroxime, fell ill again with cough, dyspnoea and fever up to 39.8 degrees C. Auscultation and lung function tests indicated respiratory tract obstruction. The chest radiograph revealed an infiltrate of the left lower lobe and bronchoscopy showed hypertrophic bronchitis. Empirical antibiotic treatment with clarithromycin (initially 500 mg twice daily, continued on half this dose) lead to rapid improvement of clinical symptoms and the patient could be discharged after 9 days. A follow-up examination 3 months later showed no abnormality. A cell culture procedure using bronchoalveolar lavage fluid obtained during bronchoscopy permitted the continuous demonstration of Chlamydia pneumoniae inclusions in HEp-2 host cells by immunofluorescence microscopy. In parallel, Chlamydia pneumoniae DNA was specifically demonstrated in the lavage fluid by use of the polymerase chain reaction. This is the first reported isolation of a replicative Chlamydia pneumoniae strain in Germany.

Adult↗
PubMed2006

ChxR is a transcriptional activator in Chlamydia.

Chlamydia spp. are obligate intracellular bacterial pathogens that alternate between two metabolically and morphologically distinct developmental forms, and differentiation depends on transcriptional regulation. Genome sequencing of Chlamydia trachomatis revealed an ORF, CT630 (chxR), whose amino acid sequence contains a winged helix-turn-helix motif similar to the DNA-binding domain of response regulators in the OmpR subfamily. ChxR differs from many response regulators in that essential residues in the receiver or phosphorylation domain are lacking. ChxR functions as a transcriptional regulator because it activated transcription of ompF and ompC when expressed in Escherichia coli. In vitro transcription combined with microarray analysis also demonstrated that ChxR activates its own expression by binding directly to sites upstream of chxR; it also activates infA, tufA, oppA, and CT084. DNase I protection studies showed that ChxR bound to sites in the ompF and ompC promoter proximal regions that overlap but were distinct from OmpR binding sites. Both proteins could bind simultaneously to their nonoverlapping binding sites. This report identifies a stage-specific transcriptional regulator and some of its target genes in Chlamydia.

Bacterial Proteins↗
PubMed2006

L,L-diaminopimelate aminotransferase, a trans-kingdom enzyme shared by Chlamydia and plants for synthesis of diaminopimelate/lysine.

The synthesis of meso-diaminopimelic acid (m-DAP) in bacteria is essential for both peptidoglycan and lysine biosynthesis. From genome sequencing data, it was unclear how bacteria of the Chlamydiales order would synthesize m-DAP in the absence of dapD, dapC, and dapE, which are missing from the genome. Here, we assessed the biochemical capacity of Chlamydia trachomatis serovar L2 to synthesize m-DAP. Expression of the chlamydial asd, dapB, and dapF genes in the respective Escherichia coli m-DAP auxotrophic mutants restored the mutants to DAP prototrophy. Screening of a C. trachomatis genomic library in an E. coli DeltadapD DAP auxotroph identified ct390 as encoding an enzyme that restored growth to the Escherichia coli mutant. ct390 also was able to complement an E. coli DeltadapD DeltadapE, but not a DeltadapD DeltadapF mutant, providing genetic evidence that it encodes an aminotransferase that may directly convert tetrahydrodipicolinate to L,L-diaminopimelic acid. This hypothesis was supported by in vitro kinetic analysis of the CT390 protein and the fact that similar properties were demonstrated for the Protochlamydia amoebophila homologue, PC0685. In vivo, the C. trachomatis m-DAP synthesis genes are expressed as early as 8 h after infection. An aminotransferase activity analogous to CT390 recently has been characterized in plants and cyanobacteria. This previously undescribed pathway for m-DAP synthesis supports an evolutionary relationship among the chlamydiae, cyanobacteria, and plants and strengthens the argument that chlamydiae synthesize a cell wall despite the inability of efforts to date to detect peptidoglycan in these organisms.

Animals↗
PubMed2001

Chlamydia trachomatis cytotoxicity associated with complete and partial cytotoxin genes.

Chlamydia trachomatis is an obligate intracellular human bacterial pathogen that infects epithelial cells of the eye and genital tract. Infection can result in trachoma, the leading cause of preventable blindness worldwide, and sexually transmitted diseases. A common feature of infection is a chronic damaging inflammatory response for which the molecular pathogenesis is not understood. It has been proposed that chlamydiae have a cytotoxic activity that contributes to this pathology, but a toxin has not been identified. The C. trachomatis genome contains genes that encode proteins with significant homology to large clostridial cytotoxins. Here we show that C. trachomatis makes a replication-independent cytotoxic activity that produces morphological and cytoskeletal changes in epithelial cells that are indistinguishable from those mediated by clostridial toxin B. A mouse chlamydial strain that encodes a full-length cytotoxin caused pronounced cytotoxicity, as did a human strain that has a shorter ORF with homology to only the enzymatically active site of clostridial toxin B. Cytotoxin gene transcripts were detected in chlamydiae-infected cells, and a protein with the expected molecular mass was present in lysates of infected epithelial cells. The protein was present transiently in infected cells during the period of cytotoxicity. Together, these data provide compelling evidence for a chlamydial cytotoxin for epithelial cells and imply that the cytotoxin is present in the elementary body and delivered to host cells very early during infection. We hypothesize that the cytotoxin is a virulence factor that contributes to the pathogenesis of C. trachomatis diseases.

Amino Acid Sequence↗
PubMed1993

Morphologic and antigenic characterization of interferon gamma-mediated persistent Chlamydia trachomatis infection in vitro.

An in vitro cell culture system was used to study the effect of interferon gamma (IFN-gamma) on Chlamydia trachomatis growth and differentiation. The effect of IFN-gamma on chlamydiae was dose-dependent. IFN-gamma at 2 ng/ml completely inhibited chlamydial growth and differentiation; however, persistent infection was established when chlamydiae were cultured with IFN-gamma at 0.2 ng/ml. Persistent infection was characterized by the development of noninfectious atypical chlamydial forms from which infectious progeny could be recovered only when IFN-gamma was removed from the culture system. Analysis of persistently infected cells by immunofluorescent microscopy and immunoblotting with specific antibodies revealed that the atypical chlamydial forms had near-normal levels of the 60-kDa heat shock protein, an immunopathologic antigen, and a paucity of the major outer membrane protein, a protective antigen. Furthermore, steady-state levels of other outer membrane constituents, such as the 60-kDa cysteine-rich outer membrane protein and lipopolysaccharide, were greatly reduced. If IFN-gamma causes similar events to occur in vivo, then persistently infected cells could augment the pathogenesis of the chronic inflammatory sequelae that follow chlamydial infection by serving as depots of antigen capable of stimulating a sustained inflammatory response.

Antibodies, Bacterial↗
PubMed2004

Structure of the Chlamydia protein CADD reveals a redox enzyme that modulates host cell apoptosis.

The Chlamydia protein CADD (Chlamydia protein associating with death domains) has been implicated in the modulation of host cell apoptosis via binding to the death domains of tumor necrosis factor family receptors. Transfection of CADD into mammalian cells induces apoptosis. Here we present the CADD crystal structure, which reveals a dimer of seven-helix bundles. Each bundle contains a di-iron center adjacent to an internal cavity, forming an active site similar to that of methane mono-oxygenase hydrolase. We further show that CADD mutants lacking critical metal-coordinating residues are substantially less effective in inducing apoptosis but retain their ability to bind to death domains. We conclude that CADD is a novel redox protein toxin unique to Chlamydia species and propose that both its redox activity and death domain binding ability are required for its biological activity.

Amino Acid Sequence↗
PubMed1993

Noninvasive detection of Chlamydia trachomatis in men: a comparison of two immunoassay tests.

This investigation compared a rapid enzyme immunoassay test and an enzyme-amplified immunoassay test with culture for the noninvasive detection of Chlamydia trachomatis urethritis in men. Urine specimens from 108 male subjects were evaluated for the presence of C trachomatis antigen, using the Kodak Surecell Chlamydia rapid enzyme immunoassay test and IDEIA Chlamydia enzyme-amplified immunoassay test. The test results were then compared with urethral C trachomatis culture and urethral Gram's stain analyses. Performance characteristics of the two tests were similar. The rapid chlamydial enzyme immunoassay test demonstrated several clinical advantages. Appropriate use of these tests may decrease patient morbidity and clarify organism etiology for enhanced specific medical care of urethritis in men.

Adult↗
PubMed1989

In-vitro activity of ofloxacin against Chlamydia trachomatis.

The in-vitro activity of ofloxacin was evaluated against recently isolated Chlamydia trachomatis strains from patients suffering from non-gonococcal urethritis. The minimal inhibitory concentration (MIC) proved to be 1 mg/l against 8 of the 10 strains assayed (the MICs for the other two strains were 0.5 and 2 mg/l). The data obtained confirm that ofloxacin is active against Chlamydia trachomatis at concentrations achievable with the routine dosage regimen. The drug may thus be regarded as potentially useful for the treatment of non-gonococcal urethritis due to Chlamydia.

Chlamydia trachomatis↗
PubMed2002

Chlamydia pneumoniae in patients undergoing surgery for thoracic aortic disease.

OBJECTIVE: To investigate if Chlamydia pneumoniae is present in the wall of the thoracic aorta in patients operated on for aneurysm or aortic dissection. DESIGN: Consecutive patients undergoing surgery for thoracic aortic aneurysm (TAA, 32 patients) and for aortic dissection (6 patients) were included in this prospective study. Tissue samples from the aorta were analysed for the presence of C. pneumoniae by polymerase chain reaction (PCR), histopathology, immunohistochemistry and in one aortic tissue sample C. pneumoniae was verified by electron microscopy and immunogold labelling technique. Cultured Hep 2 cells infected with C. pneumoniae were used as a positive control for electron microscopy. Sera for microimmunofluorescence were obtained in 36/38 and throat swabs for C. pneumoniae PCR in 17/38 patients. RESULTS: Chlamydia pneumoniae was detected by PCR in 4 of 32 TAA tissue samples (12%) and in 0 of 6 patients operated on for aortic dissection. Chlamydia pneumoniae inclusion bodies in one of the PCR positive tissue samples were verified by electron microscopy. IgG antibodies to C. pneumoniae were present in 17/31 (55%) and IgA in 15/31 (48%) of the TAA patients and in none of five tested patients with dissection. None of the tested throat swabs was positive. CONCLUSION: In this study we report the presence of C. pneumoniae by PCR and electron microscopy in the wall of TAA. A high prevalence of serum IgA antibodies to C. pneumoniae was found in TAA patients. In contrast no signs of C. pneumoniae were detected in patients with thoracic aortic dissection.

Adult↗
PubMed1996

Sphingolipids and glycoproteins are differentially trafficked to the Chlamydia trachomatis inclusion.

Chlamydia trachomatis is an obligate intracellular pathogen that multiples within the confines of a membrane-bound vacuole called an inclusion. Approximately 40-50% of the sphingomyelin synthesized from exogenously added NBD-ceramide is specifically transported from the Golgi apparatus to the chlamydial inclusion (Hackstadt, T., M.A. Scidmore, and D.D. Rockey. 1995. Proc. Natl. Acad. Sci. USA. 92: 4877-4881). Given this major disruption of a cellular exocytic pathway and the similarities between glycolipid and glycoprotein exocytosis, we wished to determine whether the processing and trafficking of glycoproteins through the Golgi apparatus to the plasma membrane in chlamydia-infected cells was also disrupted. We analyzed the processing of several model glycoproteins including vesicular stomatitis virus G-protein, transferrin receptor, and human histocompatibility leukocyte class I antigen. In infected cells, the posttranslational processing and trafficking of these specific proteins through the Golgi apparatus and subsequent transport to the plasma membrane was not significantly impaired, nor were these glycoproteins found associated with the chlamydial inclusion membrane. Studies of receptor recycling from endocytic vesicles employing fluorescently and HRP-tagged transferrin and anti-transferrin receptor antibody revealed an increased local concentration of transferrin and transferrin receptor around but never within the chlamydial inclusion. However, Scatchard analysis failed to show either an increased intracellular accumulation of transferrin receptor or a decreased number of plasma membrane receptors in infected cells. Furthermore, the rate of exocytosis from the recycling endosomes to the plasma membrane was not altered in chlamydia-infected cells. Thus, although C. trachomatis disrupts the exocytosis of sphingolipids and the Golgi apparatus appears physically distorted, glycosylation and exocytosis of representative secreted and endocytosed proteins are not disrupted. These results suggest the existence of a previously unrecognized sorting of sphingolipids and glycoproteins in C. trachomatis-infected cells.

4-Chloro-7-nitrobenzofurazan↗
PubMed2003

Chlamydia antibody response in healthy volunteers immunized with nonchlamydial antigens: a randomized, double-blind, placebo-controlled study.

Serological analysis is often used for the diagnosis of chlamydial infections. However, an increase in Chlamydia antibodies has been reported in patients with parvovirus and Mycoplasma infections. Whether this antibody response is the result of dual infection or nonchlamydial antigen stimulation is unknown. In a randomized study, 48 healthy volunteers either were immunized against yellow fever, polio, diphtheria, and tetanus (the group receiving intervention with nonchlamydial antigen) or received saline injections (the placebo group). The change in antibody levels was compared between the 2 groups. The Chlamydia recombinant lipopolysaccharide enzyme-linked immunosorbent assay (Medac) showed an increase in the antibody titer in the intervention group, compared with that in the control group (for immunoglobulin M, P=.004; for immunoglobulin A, P=.038; and for immunoglobulin G, P=.056), but no differences between study groups was found when the C. pneumoniae enzyme immunoassay (EIA; ThermoLabsystems), the C. pneumoniae EIA (Medac), and the microimmunofluorescence test (MRL) were used. An increase in antibodies to Chlamydia organisms can be measured after exposure to nonchlamydial antigens, depending on the test used.

Adult↗
PubMed2005

Analysis of synonymous codon usage bias in Chlamydia.

Chlamydiae are obligate intracellular bacterial pathogens that cause ocular and sexually transmitted diseases, and are associated with cardiovascular diseases. The analysis of codon usage may improve our understanding of the evolution and pathogenesis of Chlamydia and allow reengineering of target genes to improve their expression for gene therapy. Here, we analyzed the codon usage of C. muridarum, C. trachomatis (here indicating biovar trachoma and LGV), C. pneumoniae, and C. psittaci using the codon usage database and the CUSP (Create a codon usage table) program of EMBOSS (The European Molecular Biology Open Software Suite). The results show that the four genomes have similar codon usage patterns, with a strong bias towards the codons with A and T at the third codon position. Compared with Homo sapiens, the four chlamydial species show discordant seven or eight preferred codons. The ENC (effective number of codons used in a gene)-plot reveals that the genetic heterogeneity in Chlamydia is constrained by the G+C content, while translational selection and gene length exert relatively weaker influences. Moreover, mutational pressure appears to be the major determinant of the codon usage variation among the chlamydial genes. In addition, we compared the codon preferences of C. trachomatis with those of E. coli, yeast, adenovirus and Homo sapiens. There are 23 codons showing distinct usage differences between C. trachomatis and E. coli, 24 between C. trachomatis and adenovirus, 21 between C. trachomatis and Homo sapiens, but only six codons between C. trachomatis and yeast. Therefore, the yeast system may be more suitable for the expression of chlamydial genes. Finally, we compared the codon preferences of C. trachomatis with those of six eukaryotes, eight prokaryotes and 23 viruses. There is a strong positive correlation between the differences in coding GC content and the variations in codon bias (r=0.905, P<0.001). We conclude that the variation of codon bias between C. trachomatis and other organisms is much less influenced by phylogenetic lineage and primarily determined by the extent of disparities in GC content.

Animals↗
PubMed1995

Impact of variation in endocervical specimen collection and testing techniques on frequency of false-positive and false-negative Chlamydia detection results.

Rapid tests for detection of Chlamydia trachomatis are considerably more likely to provide accurate, reliable results if high quality endocervical specimens containing large quantities of the pathogen are submitted for testing, and if laboratories routinely detect and confirm Chlamydia at levels below the test manufacturer's recommended cut-off using previously published, well-documented guidelines that have been verified by in-house testing. Routine or periodic microscopic analysis of endocervical specimen quality may be necessary both to ensure the adequacy of specimens and to help motivate personnel performing the specimen collection procedures. False-positive test results can be significantly reduced or eliminated by confirming positive results with the use of an independent assay. Clinical laboratories currently have the opportunity to substantially improve both the sensitivity and the specificity of many currently available rapid assays for the detection of Chlamydia trachomatis.

Cervix Uteri↗
PubMed2004

Condom effectiveness for reducing transmission of gonorrhea and chlamydia: the importance of assessing partner infection status.

This analysis examined the importance of differential exposure to infected partners in epidemiologic studies of latex condom effectiveness for prevention of sexually transmitted infections. Cross-sectional, enrollment visit data were analyzed from Project RESPECT, a trial of counseling interventions conducted at five publicly funded US sexually transmitted disease clinics between 1993 and 1997. The association between consistent condom use in the previous 3 months and prevalent gonorrhea and chlamydia (Gc/Ct) was compared between participants known to have infected partners and participants whose partner infection status was unknown. Among 429 participants with known Gc/Ct exposure, consistent condom use was associated with a significant reduction in prevalent gonorrhea and chlamydia (30% vs. 43%; adjusted prevalence odds ratio = 0.42, 95% confidence interval: 0.18, 0.99). Among 4,314 participants with unknown Gc/Ct exposure, consistent condom use was associated with a lower reduction in prevalent gonorrhea and chlamydia (24% vs. 25%; adjusted prevalence odds ratio = 0.82, 95% confidence interval: 0.66, 1.01). The number of unprotected sex acts was significantly associated with infection when exposure was known (p for trend < 0.01) but not when exposure was unknown (p for trend = 0.73). Restricting analyses to participants with known exposure to infected partners provides a feasible and efficient mechanism for reducing confounding from differential exposure to infected partners in condom effectiveness studies.

Adult↗