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Detection of Chlamydia pneumoniae on cytospin preparations from bronchoalveolar lavage in COPD patients and in lung tissue from advanced emphysema

Authors Eva Brandén, Judy Gnarpe, Gunnar Hillerdal, Lotta Orre, C Magnus Sköld, et al

Published 15 January 2008 Volume 2007:2(4) Pages 643—650



Eva Brandén1, Judy Gnarpe2, Gunnar Hillerdal1, Lotta Orre3, C Magnus Sköld1, Magnus Löfdahl1, Hirsh Koyi1, Göran Tornling1

1Department of Medicine, Division of Respiratory Medicine, Karolinska Institutet, Stockholm, Sweden; 2Department of Medical Microbiology and Immunology, University of Alberta, Edmonton, Canada; 3Department of Cardiothoracic Surgery and Anaesthesiology, Karolinska University Hospital, Stockholm, Sweden

Abstract: Chronic obstructive pulmonary disease (COPD) is associated with smoking but other etiological factors contribute. Chlamydia pneumoniae is an obligate intracellular bacterium causing both acute and chronic respiratory tract infections. Studies have revealed an association between chronic C. pneumoniae infection and COPD, asthma and lung cancer but there have been difficulties detecting C. pneumoniae in the bronchial tree. Cytospin slides prepared from bronchoalveolar lavage (BAL) fluid from 14 patients with COPD, 10 healthy smokers (S) and 7 non smokers (NS) were analyzed with a fluorescein isothiocyanate labeled monoclonal antibody to C. pneumoniae. Lung tissue from 24 patients with advanced emphysema who had undergone lung volume reduction surgery (LVRS) was examined with immunohistochemistry for C. pneumoniae. Archived serum samples for detection of specific C. pneumoniae antibodies by microimmunofluorescence were available for 30 of the BAL subjects and 11 of LVRS patients. C. pneumoniae elementary body like structures were found in 29% of cytospin specimens from COPD patients, 14% of NS and 10% of HS. C. pneumoniae was detected in lung tissue in 8%. COPD patients had higher titres of IgG and IgA than NS and S. There was no association between occurrence of C. pneumoniae in BAL fluid and antibody titres. In conclusion, the assays used for detection of C. pneumoniae in lung tissue are feasible, and could be adapted in adequately powered studies to further confirm an association between C. pneumoniae infection and COPD.

Keywords: Chlamydia pneumoniae, COPD, lung tissue, bronchoalveolar lavage, cytospin