For Clinical Coronary Artery Disease

Several small pilot randomized clinical trials of antibiotic therapy for the secondary prevention of coronary artery disease have been reported. Their results are summarized below. In a small study from London(15) 60 stable post-myocardial infarction male patients who were seropositive to Chlamydia pneumoniae were randomized to receive azithromycin (500 mg day for 3 days n 28 or 500 mg day for 6 days n 12 ) or placebo and followed for 18 months, looking for the endpoints

The Role Of Macrophages In C pneumoniae Immunity

Monocytes macrophages and dendritic cells participate in the development of antigen-specific cell-mediated immunity by (1) acting as antigen-presenting cells (APC) andby (2) secretion of pro- (TNF-< x,IL-6,IL-l,IL-12) and antiinflammatory (IL-10,IL-13, TGF-p) cytokines,'7'nJ2 Wl which mediate the influence of APC into other cells of the immune system. In particular, the balance of IL-12 and IL-10 is crucial in regulating the development and functional characteristics of T cell responses....

Mechanism Of CpneumoniaeMediated Accentuation Of Autoimmune Disease

Infections and MS are intertwined processes. MS is very likely triggered by an infectious agent and, furthermore, worsening of MS is often preceded by an upper respiratory infection. We have recently examined the role of infection in experimental allergic encephalitis (EAE), an animal model of MS. EAE was recently used to evaluate a possible association of EAE with C.pneumoniae infection. Intraperitoneal inoculation of mice with C. pneumoniae, following immunization with neural antigens,...

Treatment Of C pneumoniae Respiratory Infections

Data are limited on the treatment of respiratory infections due to C. pneu-moniae. Despite the fact that many antimicrobial agents have excellent activity in vitro, as described above, in vitro activity may not always predict in vivo efficacy. Early anecdotal data suggested that prolonged therapy (i.e., at least 2 weeks') was necessary since recrudescent symptoms have been described following 2-week courses of erythromycin and even after 30 days' tetracycline or doxycycline.(3435) However,...

Animal Model For Sporadic Alzheimers Disease

We have developed a mouse model to test whether C. pneumoniae can be a primary trigger for AD pathology following a noninvasive route of inoculation.(50) Since young, naive, nontransgenic mice do not develop AD pathology, they are a suitable host for analyzing whether inoculation with this organism would lead to any pathological change in the brain. Young 3 months of age (mo) , female BALB c mice were inoculated intranasally with an isolate of C. pneumoniae obtained from an AD brain. Uninfected...

Do We Need An Antic pneumoniae Vaccine

A better knowledge of the natural history of C. pneumoniae is required in order to identify the target populations to be vaccinated against C. pneumoniae and to decide whether prophylactic and or therapeutic vaccines would be most desirable. The issue of chronic infection versus repeated infection persistent quiescent infection (which has been unquestionably shown in vitro(3)) or persistent active infection the presence of periods of reactivation and the clinical significance of super...

Conclusion Chlamydia pneumoniae Chronic Nonspecific Lung Disease Cnsld And The Dutch Hypothesis

According to Vermeire et al.,(9) the CIBA Symposium proposed chronic nonspecific lung disease (CNSLD) in 1959 as an umbrella term for chronic bronchitis, asthma, emphysema and irreversible or persistent obstructive lung disease. In 1961 Orie(23) proposed the Dutch Hypothesis which stated that CNSLD represented different expressions of a single disease entity characterized by an hereditary predisposition to develop allergy and bronchial hyper reactivity in response to environmental factors....

Ms As An Autoimmune Disease Unresolved Issues

Although current opinion favors MS to be an autoimmune disease in humans that is similar to EAE in animals, evidence of autoimmunity in MS is not without controversy.*9,10 If MS is truly an autoimmune disease, it should be possible to identify the neural antigens that are responsible for the autoimmune process. In EAE, the encephalitogenic neural antigens capable of inducing disease are well defined. In contrast, the encephalitogenic antigen (s) in MS remain unknown. Some MS patients, but not...

David L Hahn

Definition of Induction Chlamydia pneumoniae (Cpn) could have three distinguishable causal effects as an asthma inducer. First, an acute infection (or reactivation of a latent infection) could cause an acute worsening of preexisting asthma. Indeed, it is generally accepted that acute Cpn infection can cause some acute asthma exacerbations(1,2) but most evidence suggests that other organisms mainly respiratory viruses, and, to a lesser extent, Mycoplasma pneumoniae (Mpn(3)) are...

Endocarditis Cases

Marrie and coworkers reported a 59-year-old male patient with culture-negative endocarditis and aortic stenosis.(27) The patient had chills and a productive cough for 1 month preceding admission to the hospital. Serological investigations were negative or showed no rise over 3 weeks to Hepatitis B surface Ag and Ab, CMV, Coxiella burnetii, EBV, Brucella sp., Mycoplasma pneumoniae and Borrelia burgdorferi. When serum was tested with complement fixation test to Chlamydia group antigen, the titer...

Chlamydia Antigen Detection By Immunostaining

Demonstration of bacterial DNA by PCR is considered only indirect evidence because the PCR is based on the amplified results. Therefore, many technical pitfalls can affect the final results and false-positive or -negative results are easily introduced, as discussed above. In this regard, direct demonstration of C. pneumoniae by immunostaining with specific antibody is considered more specific in some studies. However, the chance to capture chlamydia antigen by staining should be low because the...

Persistent Infection And Aberrant Forms

C. pneumoniae is regarded as a common cause of respiratory tract infections and it can cause prolonged or chronic infections which may be due to persistence for months or years.(14,30) These persistent infections have been implicated in the development of a number of chronic diseases including atherosclerosis, asthma, and obstructive pulmonary diseases (see other chapter) . These persistent chlamydial infections can be established in vitro using several methods involving cytokines,(31-34)...

Joseph Ngeh and Sandeep Gupta l Introduction

Atherosclerosis is now acknowledged as an inflammatory disease. 1-7 The major clinical manifestations of atherosclerotic disease include coronary heart disease CHD , ischemic stroke, abdominal aortic aneurysm AAA , and peripheral arterial disease PAD . These in turn are among the leading causes of death and disability in the world. However, only about 50 of the occurrences of these conditions can be attributed to classical vascular risk factors such as hypertension, smoking, diabetes mellitus,...

Morphology Of Eb

Chlamydia Pneumoniae Ar39 Infection

The morphology of EBs has been proposed as one of the criteria for distinguishing C. pneumoniae from other chlamydial species. 11' 12 The EBs of the C. pneumoniae TW-183 and AR TWAR strains have a wide periplasmic space limited by a wavy outer membrane, creating pear-shaped profiles in thin sections Fig. 4a,b . In contrast, the EBs of the KKpn strains, which were isolated in Kawasaki Medical School Hospital and number from 1 to 18, were found to be round in shape with a narrow periplasmic space...

Structure Of The Outer Membrane

Chlamydia Pneumoniae

EBs of all chlamydial species are stable against mechanical agitation, such as that from ultrasonic, freeze-thawing, or osmotic shock. To improve this prop erty, EBs can be recovered from infected cells at an extremely high level of purity. 16'20 Peptidoglycan PG is an ubiquitous cell wall component that is re sponsible for the rigidity of free-living bacteria. However, no positive evidence for the presence of PG and its precursor has been documented by biochemical anal yses of chlamydial...

Chlamydial Life Cycle And Persistence

Chlamydia Persistence Cycle

Chlamydiae exhibit a unique obligate intracellular life cycle that is essential for understanding their virulence in both acute and chronic disease. These bacteria have a biphasic life cycle that alternates between a metabolically inert, infectious elementary body EB and a noninfectious, metabolically active reticulate body RB see ref. 12 for review . The molecular events of chlamy-dial growth and differentiation have yet to be defined, but their intracellular life cycle has been sufficiently...

C pneumoniae Vaccine Development

The complex biology and antigenic composition and the fact that infec tion may generate both protective and pathological immune responses present obstacles in achieving a C. pneumoniae vaccine. Chlamydial infections often recur or remain persistent, indicating absence of sterilizing immunity. However, studies in an experimental model of infection with the related organism C. trachomatis indicate a short-lived immunity after natural infection. The resistance to genital chlamydial diseases...

Joseph B Muhlestein

Animal Studies of Chlamydia pneumoniae, Atherosclerosis and 3. Observational Studies of the Effect of Antimicrobials on the 4. Randomized Secondary Prevention Trials for Clinical Peripheral 5. Randomized Secondary Prevention Trials for Clinical Coronary 6. Ongoing Clinical Antiinfective 183 13. Chlamydia pneumoniae and 187 14. Chlamydiapneumoniae as a Candidate Pathogen in CHARLES W. STRATTON and SUBRAMANIAM SRIRAM 2. Autoimmune Basis for MS 199 3. MS as an Autoimmune Disease Unresolved...