Chronic infection with Chlamydia pneumoniae in asthma: a type-2 low infection related phenotype.

BACKGROUND: Chlamydia pneumoniae and Mycoplasma pneumoniae have been implicated in the pathogenesis of asthma and are responsible for chronic inflammation when host immune system fails to eradicate the bacteria. METHOD: We performed a prospective study on 410 patients who underwent a visit at the asthma clinic of CHU of Liege between June 2016 and June 2018 with serology testing for C. pneumoniae and M. pneumoniae. RESULTS: 65% of our asthmatic population had serum IgA and/or IgG towards C. pneumoniae, while only 12.6% had IgM and/or IgG against M. pneumoniae. Compared to seronegative asthmatics, asthmatics with IgA+ and IgG+ against C. pneumoniae were more often male and older with a higher proportion of patients with smoking history. They received higher doses of inhaled corticosteroids (ICS) and displayed lower FEV1/FVC ratio, higher RV/TLC ratio and lower conductance. They had higher levels of fibrinogen, though in the normal range and had lower sputum eosinophil counts. Patients with IgA- and IgG+ against C. pneumoniae were older and had higher blood monocyte counts and alpha-1-antitrypsin levels as compared to seronegative patients. Patients with IgM and/or IgG towards M. pneumoniae were more often males than seronegative asthmatics. In a subpopulation of 14 neutrophilic asthmatics with Chlamydia pneumoniae IgA + /IgG + treated with macrolides, we found a significant decrease in blood neutrophils and normalization of sputum neutrophil count but no effect on asthma quality of life and exacerbations. CONCLUSION: Positive Chlamydia serologic test is more common than positive Mycoplasma serology. Asthmatics with IgA and IgG against C. pneumoniae have more severe disease with increased airway obstruction, higher doses of ICS, more signs of air trapping and less type-2 inflammation.

Clinical study of chlamydia pneumoniae infection in patients with coronary heart disease.

BACKGROUND: This study aims to investigate the chlamydia pneumoniae infection (PC) in patients with coronary heart disease. METHODS: A total of 92 patients with coronary heart disease, who were treated with percutaneous coronary intervention (PCI), were selected as the case group. In addition, 50 healthy people were enrolled as the control group. The incidences of CP infection and serum Chlamydia pneumoniae IgA antibody (CP-IgA), high sensitive C-reactive protein (hs-CRP), and interleukin-6 (IL-6) were compared in these two groups. The classification of coronary artery lesion, the incidence of perioperative cardiovascular events, and adverse prognosis events within six months after procedure were compared. RESULTS: The incidence of CP infection in the case group was higher (42.4% vs. 0%, P < 0.05). Furthermore, 17 patients were at grade I, 39 patients were at grade II, and 36 patients were at grade III. The incidences for these three kinds of patients were 17.6, 30.8, and 66.7%. The incidence of CP infection at grade III was higher than that of grade I or II (P < 0.05). Serum CP-IgA, hs-CRP and IL-6 levels increased with the severity of the coronary artery disease (P < 0.05), and the serum hs-CRP and IL-6 levels of patients with perioperative cardiovascular events were higher (P < 0.05). Moreover, the serum CP-IgA levels of the patients with adverse prognosis events were also higher (P < 0.05). CONCLUSIONS: Patients with coronary heart disease have a high CP infection rate. The degree of infection is relevant to the severity of the coronary artery lesions and postoperative prognosis of patients, suggesting that CP infection may be an important factor affecting the incidence and prognosis of coronary heart disease.

Chlamydia pneumoniae Induces Interferon Gamma Responses in Peripheral Blood Mononuclear Cells in Children with Allergic Asthma.

Respiratory infections caused by Chlamydia pneumoniae have been associated with exacerbations of asthma. Cell-mediated immunity (CMI) is critical for maintaining immunity. We compared interferon (IFN)-γ responses in C. pneumoniae-infected peripheral blood mononuclear cells (PBMC) in paediatric patients ± asthma. Presence of C. pneumoniae was tested from asthma patients (N = 17) and non-asthmatic controls (N = 16) (PCR). PBMC were infected for 1 h ± C. pneumoniae AR-39 (MOI = 0.1) and cultured for 48 h. IFN-γ levels were measured in supernatants (ELISA). C. pneumoniae-IgG antibodies in serum were determined (MIF). All subjects tested negative for C. pneumoniae (PCR). C. pneumoniae-induced IFN-γ production in vitro was more prevalent in asthma compared with non-asthma; levels of IFN-γ were higher in asthma compared with non-asthma (P = 0.003). There was no association between recent respiratory infection and positive IFN-γ responses. These data show that C. pneumoniae modulates IFN-γ responses in patients with asthma, even in absence of active infection.

Chlamydia pneumoniae and Helicobacter pylori IgG seropositivities are not predictors of osteoporosis-associated bone loss: a prospective cohort study.

The potential link between infection with Chlamydia pneumoniae or Helicobacter pylori and osteoporosis has not been investigated in population-based longitudinal studies. A total of 250 healthy postmenopausal women who participated in a prospective cohort study were evaluated for IgG antibodies directed against C. pneumoniae and H. p ylori, osteoprotegerin (OPG), the receptor activator of nuclear factor kappa B ligand (RANKL), CrossLaps, and osteocalcin. Bone mineral density (BMD) was measured at the femoral neck and lumbar spine at baseline and at follow-up 5.8 years later. There were no significant differences in age-adjusted bone turnover markers, OPG, RANKL, the RANKL/OPG ratio, and BMD between the C. p neumoniae and H. p ylori IgG seropositive and seronegative subjects (P > 0.05). Neither C. p neumoniae nor H. p ylori IgG seropositivity was associated with age-and body mass index-adjusted BMD at the femoral neck and lumbar spine or bone loss at the 5.8-year follow-up. In logistic regression analysis, neither C. p neumoniae nor H. p ylori IgG seropositivities predicted incident lumbar or spine osteoporosis 5.8 years later. In conclusion, neither C. p neumoniae nor H. p ylori IgG seropositivity was associated with bone turnover markers, the RANKL/OPG ratio, BMD, or bone loss in postmenopausal women. In addition, chronic infection with C. p neumoniae or H. p ylori did not predict incident osteoporosis among this group of women.

SPECIFIC SERUM IMMUNOGLOBULIN G AGAINST CHLAMYDIA PNEUMONIAE IN HEALTHY CHILDREN AND ADULTS IN SOUTH-EAST OF IRAN.

BACKGROUND: Chlamydia pneumoniae (C. pneumonia) is an obligate intracellular bacterium and recognized as a risk factor for several diseases such as asthma, atherosclerosis and arthritis. The aim of this study was to determine the seroprevalence of C. pneumonia in healthy subjects in different age groups. METHODS: The serum levels of anti C. pneumonia IgG were measured by using of ELISA. RESULTS: Totally, 630 subjects (164 children and 466 adults) were included into study. The seroprevalence and the mean titer of anti C. pneumonia antibody were 11.3% and 14.48?2.18 RU/mL; at age 510 years, 15% and 17.47 +/- 2.40 RU/mL at age 11-20 years, 21% and 25.15 +/- 4.56 RU/mL at age 21-30 years group, 40% and 53.77 +/- 6.40 RU/mL at age 31-40 years, 94% and 146.41 +/- 8.95 RU/mL at age 41-50 years, 98% and 153.59 +/- 10.38 RU/mL at age 51-60 years, 96% and 138.80 +/- 12.78 RU/mL at age 61-70 years, respectively. The differences of the seroprevalence and the mean titer of anti C. pneumonia antibody between age groups were significant (p<0.0001). The sero-prevalence and the mean titer of anti C. pneumonia antibody were 11.6% and 14.33 +/- 1.49 RU/mL in children and 65.5% and 97.40 +/- 4.46 RU/mL in adults. The seroprevalence and the mean titer of anti C. pneumonia antibody were significantly higher in adults in comparison with those in children (p<0.0001). CONCLUSION: These findings showed that the sero- prevalence and titer of anti C. pneumonia IgG were increased with advanced ages and were higher in adults as compared to children.

Seroprevalence of Chlamydophila abortus infection in yaks (Bos grunniens) in Qinghai, China.

Chlamydophila abortus is an important amphixenosis which in a wide range of animals, associated with reproductive disorders in yaks. In order to assess the prevalence of this infection in yaks in Qinghai, China, a cross-sectional study was carried out, and a total of 674 serum samples were collected from June to October 2012 in six counties, and antibodies to C. abortus were examined by indirect hemagglutination (IHA) test. The overall seroprevalence of C. abortus in yaks was 17.66 % (119/674), and the seroprevalence of antibodies to C. abortus in yaks ranged from 11.82 to 28.43 % among the six different areas, and the difference was statistically significant (P < 0.05). The seropositivity of C. abortus infection in different age groups varied from 16.33 to 18.49 %, and prevalence in yaks of ≥3 year (18.49 %) was slightly higher than that in yaks of <3 year, but the differences among the age groups were not statistically significant (P > 0.05). The seroprevalence of C. abortus infection in male yak (16.8 %) was slightly lower than that in females (17.85 %), and the difference was not statistically significant (P > 0.05). So far, this is the first systematic and comprehensive investigation of C. abortus infectionin in yaks in this area.

Chlamydia pneumoniae and osteoporosis-associated bone loss: a new risk factor?

UNLABELLED: We found an association between the presence of Chlamydia pneumoniae DNA both in osteoporotic bone tissue and peripheral blood mononuclear cells (PBMCs) and the increase in circulating resorptive cytokines. INTRODUCTION: Our study was designed to determine whether C. pneumoniae infection may be involved in osteoporosis-associated bone loss. METHODS: The study included 59 women undergoing hip joint replacement surgery for femoral neck fracture: 32 with osteoporosis and 27 with osteoarthritis. A total of 118 tissue specimens (59 bone tissues, 59 PBMCs) were examined for C. pneumoniae DNA by real-time polymerase chain reaction (PCR). Serum levels of soluble receptor activator of nuclear factor kappa B ligand (sRANKL), osteoprotegerin (OPG), interleukin (IL)-1ß, tumor necrosis factor-α, and IL-6 were also measured. RESULTS: C. pneumoniae DNA was detected in osteoporotic bone tissue whereas it was not found in non-osteoporotic bone tissue (p < 0.05). A significantly higher rate of C. pneumoniae DNA (p < 0.05) was found in PBMCs of osteoporotic patients than in those of osteoarthritis patients. Among osteoporotic patients, serum sRANKL, IL-1, and IL-6 concentrations as well as sRANKL/OPG ratio significantly differ between patients with bone tissue and PBMCs positive to C. pneumoniae and C. pneumoniae-negative patients. CONCLUSION: The association between the presence of C. pneumoniae DNA, both in bone tissue and PBMCs, and the increase in sRANKL/OPG ratio as well as in IL-1ß and IL-6 levels observed in osteoporotic patients suggests C. pneumoniae infection as a new risk factor for osteoporosis.

Dual-color bioluminescent assay using infected HepG2 cells sheds new light on Chlamydia pneumoniae and human cytomegalovirus effects on human cholesterol 7α-hydroxylase (CYP7A1) transcription.

Chlamydia pneumoniae and human cytomegalovirus (HCMV) are intracellular pathogens able to infect hepatocytes, causing an increase in serum triglycerides and cholesterol levels due to the production of inflammatory cytokines. We investigated whether these pathogens could interfere with cholesterol metabolism by affecting activity of hepatic cholesterol 7α-hydroxylase (CYP7A1) promoter. CYP7A1 is the rate-limiting enzyme responsible for conversion of cholesterol to bile acids, which represents the main route of cholesterol catabolism. A straightforward dual-reporter bioluminescent assay was developed to simultaneously monitor CYP7A1 transcriptional regulation and cell viability in infected human hepatoblastoma HepG2 cells. C. pneumoniae and HCMV infection significantly decreased CYP7A1 promoter activity in a dose-dependent manner, with maximal inhibitions of 33±10% and 32±4%, respectively, at a multiplicity of infection of 1. To support in vitro experiments, serum cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and glucose levels were also measured in Balb/c mice infected with C. pneumoniae. Serum cholesterol and triglycerides also increased in infected mice compared with controls. Although further investigation is required, this work presents the first experimental evidence that C. pneumoniae and HCMV inhibit CYP7A1 gene transcription in the cultured human hepatoblastoma cell line.

[The dynamics of detection of antibodies class G against Chlamydia pneumoniae and Chlamydia psittaci in blood serum of patients of different age groups].

The detection of antibodies class G in blood serum of patients of different age groups was carried out in 2005-2010. The analysis permitted to establish the peak of activity of chlamydiae infection in 2006 and increase of activity of morbidity in 2010.

The association of body mass index, waist and hip circumference, and waist-hip ratio with Chlamydia pneumoniae IgG antibodies and high-sensitive C-reactive protein at 31 years of age in Northern Finland Birth Cohort 1966.

BACKGROUND: Viruses and bacteria like Chlamydia pneumoniae and Helicobacter pylori have been suggested to have a role in pathogenesis of overweight and obesity. OBJECTIVE: We studied whether C. pneumoniae-specific IgG antibodies are associated with elevated body mass index (BMI), waist and hip circumference, and/or waist-hip ratio (WHR), and whether the risk is more pronounced in the simultaneous presence of an ongoing inflammation as measured by elevated high-sensitive C-reactive protein (hsCRP) levels. SUBJECTS AND METHODS: Our study population was derived from the Northern Finland Birth Cohort 1966 (NFBC1966), a general population sample of 12,058 live-born children. This cross-sectional study consisted of 5044 persons at 31 years of age. Serum C. pneumoniae IgG titers were measured by microimmunofluorescence test, and hsCRP levels by immunoenzymometric assay. RESULTS: C. pneumoniae IgG positivity (titer ≥ 32), both alone and jointly with elevated hsCRP (≥ 1.64 mg l(-1), an upper quartile), was found to significantly associate with elevated BMI in the whole study population and with elevated hip and waist circumference in women, yet no association with WHR was seen. The analyses were adjusted for sex (when appropriate), smoking, socioeconomic position, glucose, insulin, high- and low-density lipoprotein cholesterols, triglycerides, leukocytes and pulse pressure. CONCLUSION: These findings suggest that especially in women, persistent C. pneumoniae infection may be associated with overweight/obesity, independently of more traditional risk factors.

Increased expression of CD11a and CD45 on leukocytes and decreased serum TNF-alpha levels in patients with isolated coronary artery ectasia.

BACKGROUND: Aneurysm and ectasia have similar pathological pathways. TH2-associated cytokines are stimulated by aneurismal tissue and correspondingly lack mediators associated with TH1 response. In this study, we measured serum TNF-alpha and IL-18 levels which are strong TH1 stimulating cytokines and also investigated the expression of CD11a, CD11b, CD18 adhesion molecules and CD45 on leukocytes in patients with coronary artery ectasia (CAE) and controls with normal coronary arteries (NCA). METHODS: A total of 51 isolated CAE patients free of atherosclerosis and 37 NCA controls were included in the study. Cell counts and cell surface adhesion molecules were detected by flow cytometry using fluorescence conjugated monoclonal antibodies. Serum TNF-alpha, IL-18 levels, and Chlamydophila pneumoniae IgG and IgM and Helicobacter pylori IgG levels were detected by ELISA methods. RESULTS: The mean fluorescence intensities of CD11a on granulocytes, monocytes and lymphocytes and CD45 on granulocytes and monocytes were significantly higher in CAE patients when compared with the NCA group (10.01 +/- 8.2 vs. 6.79 +/- 3.49, p = 0.04; 15.84 +/- 8.64 vs. 11.56 +/- 5.27, p = 0.016; 29.58 +/- 9.98 vs. 20.02 +/- 9.66, p < 0.001; 7.58 +/- 5.03 vs. 4.57 +/- 3.05, p = 0.003; 18.73 +/- 1238 vs. 10.74 +/- 738, p = 0.004; respectively) detected by flow cytometry. TNF-alpha levels were significantly lower in the patient group (18.76 +/- 7.07 vs. 24.29 +/- 8.46; p < 0.001) when compared with controls. The percentage of granulocytes was higher in the CAE group when compared with the NCA group (65.52 +/- 14.91 vs. 52.28 +/- 1537; p = 0.002). Contrarily, the percentage of monocytes was higher in the control group when compared with the CAE group (18.12 +/- 15.69 vs. 934 +/- 733 p = 0.008). Among the infection markers studied, only C. pneumoniae IgG levels were significantly higher in patients when compared with controls (81.62 +/- 48.53 RU/mL vs. 63.79 +/- 33.83 RU/mL; p = 0.045). In CAE patients, TNF-alpha levels significantly correlated with mean fluorescence intensity levels of CD45+ granulocyte (0.525, p < 0.001), monocyte (0.469, p = 0.001) and lymphocytes (0376, p = 0.013). CONCLUSIONS: The decreased levels of TNF-alpha may indicate predominance of TH2 and lack of TH1 type immunity in CAE patients, similar to patients with aortic aneurysms. Increased levels of cell surface adhesion molecules in CAE are an indicator of activation of leukocytes for adherence and transmigration through the vessels for the initiation of inflammation.

The relationship between seropositivity against Chlamydia pneumoniae and stroke and its subtypes in a Latvian population.

BACKGROUND AND OBJECTIVE: Serological evidence of infection with Chlamydia pneumoniae has been associated with cardiovascular diseases, but the relationship with stroke and its risk factors remains not completely understood. The aim of this study was to determine whether serological evidence of infection with Chlamydia pneumoniae was associated with the risk of ischemic stroke and any of investigated stroke subtypes. MATERIAL AND METHODS: Confirmed stroke cases (n=102) were compared with gender- and age-matched control patients (n=48). The patients with stroke were divided into 3 groups according to the TOAST criteria: atherothrombotic (n=36), cardioembolic (n=47), and of undetermined etiology (n=19). Plasma levels of IgG antibodies to Chlamydia pneumoniae were measured by enzyme-linked immunosorbent assay. RESULTS: There was a significant association between seropositivity to Chlamydia pneumoniae and stroke. Anti-Chlamydia pneumoniae IgG antibodies were detected in 64 case patients (62.7%) and 17 control patients (35.4%) (χ(2)=9.8; df=1; P=0.002). IgG seropositivity to Chlamydia pneumoniae was linked to all the analyzed etiological subtypes of stroke. CONCLUSION: This study showed that IgG seropositivity to Chlamydia pneumoniae was associated with stroke and all the analyzed etiological subtypes of stroke.

A prospective study of multiple donor exposure blood recipients: surveillance value and limitations for hemovigilance.

BACKGROUND: There have been few recent systematic studies of blood recipients for direct evidence of blood safety, especially for emerging pathogens that may pose a threat to the blood supply. STUDY DESIGN AND METHODS: Recipients who would likely require transfusion from multiple donors were recruited and a blood specimen was collected before their first study transfusion and at intervals after their study transfusion(s). Blood samples associated with the units that were transfused to enrolled recipients were also collected. Part of each recipient specimen and selected donor specimens was tested for the targeted blood-borne agents, parvovirus B19 (B19) and Chlamydia pneumoniae (Cp), that were piloted in this study, and the remaining material was kept in a repository. RESULTS: Between April 2004 and December 2006, a total of 120 recipients were recruited with 4047 subsequent donor exposures. On average, each recipient was followed up seven times. Of recipients who were adequately followed up and were initially immunoglobulin G antibody negative, one in 31 and one to two in 49 seroconverted to B19 and Cp after a total of 922 and 1413 evaluable transfusions, respectively. The detection of seroconversion was complicated by passively acquired donor antibodies for these two seroprevalent agents. Negative results for nucleic acids of the agents limited our ability to further clarify the relationship of these seroconversions to transfusion-transmitted infection. CONCLUSION: The risk of transfusion-associated B19 infection appears to be low but no conclusion of transfusion transmission can be made for Cp. The approach piloted through this study offers added value beyond the current hemovigilance strategy in the United States.

Chlamydia pneumoniae infection is associated with elevated body mass index in young men.

Chlamydia pneumoniae infection is said to be associated with obesity. We studied the association between C. pneumoniae infection and inflammation and increased BMI in 891 Finnish military recruits. IgG seropositivity in arrival and departure serum samples during 6-12 months of military service was considered as persistence of antibodies and a possible indication of chronic infection. Persistently high C-reactive protein (CRP) level (elevated on arrival and departure) (OR 2.2, 95% CI 1.3-3.9), and persistent C. pneumoniae antibodies (OR 2.1, 95% CI 1.5-2.8) were significant risk factors for overweight (BMI 25 kg/m2). In addition, those who had persistent antibodies and persistently elevated CRP levels, or those who had either of them, had a significantly higher BMI (kg/m2) compared to those who had neither of them (25.8 vs. 24.6 vs. 23.5, respectively; P<0.001). These results provide new information about the association between possible chronic C. pneumoniae infection and obesity in young men.

Detection of Chlamydia pneumoniae in peripheral blood mononuclear cells of healthy blood donors in Tehran Regional Educational Blood Transfusion Centre.

Chlamydia pneumoniae is a common pathogen in the world often causing upper or lower respiratory tract infection and may also be linked to some chronic inflammatory diseases. Recent studies have shown that a high percentage of healthy blood donors harbour Chlamydia DNA and antigens. The objective of this study was to investigate the presence of this microorganism among blood donors. Blood samples were collected between November 2004 and March 2005 from 196 healthy blood donors. Ten millilitre of blood was collected in ethylenediaminetetraacetic (EDTA) tube. Reverse transcription of RNA was performed with Moloney murine leukaemia virus (MMLV) reverse transcriptase and random primers hexamer. Polymerase chain reaction products were evaluated by electrophoresis. Data were analysed using the chi(2) test and t-test. Of the 196 healthy blood donors, 7.1% were C. pneumoniae DNA positive (CI 95 % = 3.51- 10.69), which is slightly higher in female (8.5%) than male (6.5%) donors; this difference was not found to be significant (P = 0.4). The average age of study groups was 40.84 (SD +/- 10.80) years; significant association was not found between age groups and the presence of C. pneumoniae DNA. There was no significant differences between positive rate and first-time [37 (19.3%)] and repeat [155 (80.7%)] donors. C. pneumoniae DNA seems to be frequent in apparently healthy blood donors; therefore, it can be a threat for blood safety. But further studies are needed to evaluate the survival of C. pneumoniae in blood bank conditions and in blood recipients to define the clinical importance of such findings. Elimination of intracellular bacteria by filtration is an effective strategy for risk reduction.

Comparative evaluation of eight serological assays for diagnosing Chlamydophila abortus infection in sheep.

Chlamydophila abortus is one of the principal causes of late-term abortion (enzootic abortion of ewes or EAE) in sheep across Europe. Serological diagnosis of EAE is routinely carried out by the complement fixation test, although the interpretation of results can often be difficult because of cross reaction with Chlamydophila pecorum, which also commonly infects sheep. The purpose of this study was to evaluate and compare four ELISAs developed at Moredun Research Institute and based on whole C. abortus elementary bodies (EBs), an outer membrane preparation of the whole organism (SolPr) and two recombinant polymorphic outer membrane protein fragments (rOMP90-3 and rOMP90-4), with 3 commercial tests, the CHEKIT Chlamydophila Abortus, Pourquier ELISA Chlamydophila abortus and ImmunoComb Ovine Chlamydophila Antibody tests. The tests were evaluated using a panel of 202 sera from experimentally and naturally infected animals, as well as from EAE-free flocks. The EB, SolPr and CHEKIT ELISAs performed similarly to the CFT, all lacking in specificity by cross reacting with sera from C. pecorum infected animals. The ImmunoComb also lacked specificity with C. pecorum sera, but also badly cross reacted with sera from EAE-free flocks. The rOMP90-3, rOMP90-4 and Pourquier ELISAs were the most specific, although the Pourquier test appeared less sensitive with sera from naturally infected animals. Overall, the rOMP90-3 ELISA performed the best, with high sensitivity (96.8%) and no cross reaction with sera from C. pecorum infected animals or from EAE-free flocks (100% specificity) and so would be a suitable alternative to the CFT for the serological diagnosis of EAE.

Association of plasma circulatory markers, Chlamydia pneumoniae, and high sensitive C-reactive protein in coronary artery disease patients of India.

Plasma inflammatory markers have been shown to be predictors for cardiovascular risk, however, there is no study where the levels of plasma circulatory markers have been evaluated in coronary artery disease patients (CAD pts) positive for C. pneumoniae IgA and high sensitive C-reactive protein (hsCRP) which may help in better understanding of disease pathogenesis. A total of 192 patients and 192 controls attending the Cardiology Outpatient Department of Safdarjung Hospital were enrolled. The levels of plasma circulatory inflammatory markers were evaluated by ELISA. The levels of circulatory plasma markers (IL-4, IL-8, IL-13, ICAM-1, and VCAM-1) were significantly higher, whereas, levels of IL-10 and IFN-gamma were significantly lower in CAD pts compared to healthy controls. The levels of IL-4, IL-8, and ICAM-1 (P = .007, .015, and .048) were significantly higher, however, IL-10 and IFN-gamma were significantly lower (P < .001, < .001) in C. pneumoniae IgA positive CAD pts. The levels of IL-4, IL-8, IL-13, ICAM-1, and VCAM-1 were higher but not significant and levels of IL-10 and IFN-gamma were significantly (P < .001, < .001) lower in hsCRP positive CAD pts. Our study suggested that circulatory cytokines, namely, IL-4, IL-8, and adhesive molecules like ICAM-1 were enhanced after infection with C. pneumoniae whereas in contrast to this IL-10 and IFN-lambda were lowered. Suggesting the important role of these cytokines in progression of CAD.

What is your diagnosis? Blood smear from an injured red-tailed hawk.

An injured juvenile red-tailed hawk (Buteo jamaicensis) was evaluated at the Veterinary Medical Teaching Hospital at the University of California, Davis. The hawk was quiet, alert, and emaciated, and had a closed comminuted, mid-diaphyseal ulnar fracture. CBC results included heterophilia with a left shift, monocytosis, and increased plasma fibrinogen concentration. The blood smear included rare heterophils containing small, dark blue inclusions approximately 1-2 mum in diameter that ranged from round to coccobacillary in shape and formed variably shaped aggregates; the morphology of the inclusions was suspicious for Chlamydophila or Ehrlichia spp. pathogens. The hawk died, and histopathologic examination of tissues obtained at necropsy found severe multifocal histiocytic and heterophilic splenitis in addition to chronic hepatitis, myocarditis and epicarditis, meningoencephalitis, and airsacculitis. Using immunohistochemistry the presence of Chlamydia/Chlamydophila spp. antigen within multiple tissues was confirmed. Chlamydophila psittaci DNA was demonstrated in whole blood and fresh splenic tissue via real-time PCR. Direct fluorescent antibody staining of air-dried blood smears was positive in rare leukocytes for Chlamydia/Chlamydophila spp. antigen, and immunocytochemical staining of blood smears for Chlamydia/Chlamydophila spp. antigen was focally positive in rare heterophils. These findings may represent the first reported diagnosis of natural avian C. psittaci infection by visualization of organisms in peripheral blood heterophils. Immunocytochemical evaluation of blood smears was valuable in confirming the diagnosis and may be a useful antemortem test to discriminate between bacteria and other inclusions within heterophils.

[Intervention of Huanglian Jiedu decoction on haemorheology and cholesterol-supplemented diet].

OBJECTIVE: To study the influence of Chlamydia pneumonia (Cpn) infection on haemorheology and atherosclerosis and the intervention of Huanglian Jiedu decoction (HJT). METHOD: At the beginning of the experiment, all the sixty New-Zealand rabbits were token blood to test Cpn IgG and all the results were negative. Eight New-Zealand rabbits were randomized into normal group F, and all other rabbits were fed with forage containing 2.5 g x kg(-1) cholesterol and infected with Cpn via nasophrynx for three times during 6 weeks. At the end of the sixth week, forty-four rabbits with serum Cpn IgG positive were randomized into four groups: Group A treat with HJD 2 g x kg(-1) d(-1) by gastric gavage, group B with HJT 1 g x kg(-1) x d(-1), group C with azithromycin 20 mg x kg(-1) x d(-1), model group D with normal saline for six weeks. Group E was set up in eight rabbits with serum Cpn IgG negative and served as the control. At the end of 18th week, blood was token from middle ear artery to test haemorheology such as whole blood viscosity, plasma viscosity, haematocrit, erythrocyte aggregation index (EAI), erythrocyte rigidity index (IRI), and erythrocyte deformability index (EDI). After that, all the rabbits were executed and the pathological features of aorta tissue were observe under microscope. RESULT: Haemorheological disorder and atherosclerotic changes were obvious in both group D and E. while maximum intimal thickness (MIT) (23.65 +/- 8.19 vs 12.76 +/- 4.06), atherosclerotic damage percentage (P(LCI)) (41.08 +/- 12.51 vs 22.43 +/- 9.45), plaque area index (I(PA)) (9.57 +/- 1.82 vs 2.84 +/- 0.25) in group D was much higher than that in group E (all P < 0.01). Compare with group D, haemorphological disorder and atherosclerotic changes were much improved in group A, B and C. MIT (6.45 +/- 1.27 vs 23.65 +/- 8.19), (P < 0.01), P(LCI) (22.39 +/- 6.74 vs 41.08 +/- 12.51), (P < 0.05) and I(PA) (1.44 +/- 0.33 vs 9.57 +/- 1.82), (P < 0.01) in group A was much lower than that in group D. And MIT (12.65 +/- 3.63 vs 23.65 +/- 8.19), (P < 0.01) and I(PA) (4.43 +/- 1.17 vs 9.57 +/- 1.82), (P < 0.05) in gruoup B was much lower than that in group D too. CONCLUSION: Cpn infection could aggravate the haemorheology disorder in cholesterol-supplemented-diet rabbits, and both antidotal decoction of Coptis and azithromycin can alleviate it.

Chlamydophila pneumoniae DNA and mRNA transcript levels in peripheral blood mononuclear cells and cerebrospinal fluid of patients with multiple sclerosis.

Chlamydophila pneumoniae DNA and mRNA transcripts were investigated by PCR and RT-PCR in fresh CSF and PBMC specimens co-cultured in Hep-2 cell lines and collected from 14 patients with definite RR MS and 19 patients with other inflammatory (OIND) and non-inflammatory (NIND) neurological controls. A positivity for C. pneumoniae DNA and mRNA was detected in CSF and PBMCs of 9 RR MS patients (64.2%) with evidence of disease activity, whereas only 3 controls were positive for Chlamydial DNA. These preliminary findings suggest that C. pneumoniae may occur in a persistent and metabolically active state at both peripheral and intrathecal levels in MS, but not in OIND and NIND.