沙眼衣原体感染对大鼠着床期间子宫内膜上皮细胞的影响

目的:研究沙眼衣原体(Ct)感染后大鼠着床期间子宫内膜形态学改变及肌动蛋白的变化。方法:大鼠雌雄合笼建立早孕模型,取正常妊娠组和Ct感染后妊娠组大鼠子宫,采用扫描电镜(SEM)观察子宫内膜超微结构改变及荧光免疫组化检测肌动蛋白的表达。结果:SEM示对照组子宫腔可见有微绒毛的分泌细胞;实验组腔上皮细胞表面有的可见破损,微绒毛少见;免疫组化结果显示荧光强度主要定位于腔上皮细胞胞质/胞膜,妊娠第4,5,6天沿胞质顶部分布较密集,而底部较弥散;妊娠第7天顶部强度有所增加;感染组的荧光强度均弱于相应正常组,在妊娠第5天存在显著性差异(P<0.05)。结论:沙眼衣原体感染后可能通过破坏子宫腔上皮分泌细胞,进而影响其内成分肌动蛋白,从而干扰早期妊娠。     

Emerging Chlamydial Infections

Chlamydiae are important intracellular bacterial pathogens of vertebrates. In the last years, novel members of this group have been discovered: Parachlamydia acanthamoebae and Simkania negevensis seems to be emerging respiratory human pathogens, while Waddlia chondrophila might be a new agent of bovine abortion. Various species have been showed to infect also the herpetofauna and fishes, and some novel chlamydiae are endosymbionts of arthropods. In addition, molecular studies evidenced a huge diversity of chlamydiae from both environmental and clinical samples, most of such a diversity could be formed by novel lineages of chlamydiae. Experimental studies showed that free-living amoebae may support multiplication of various chlamydiae, then could play an important role as reservoir/vector of chlamydial infections. Here we reviewed literature data concerning chlamydial infections, with a particular emphasis on the novely described chlamydial organisms.     

Chlamydia trachomatis in term pregnancy. isolation and serological study with a case report

The prevalence of cervical Chlamydia trachomatis infection in healthy, symptomless full-term pregnant women (n = 92) was found to be low (1.1%). Chlamydial cervical IgA antibodies, as measured by solid-phase radioimmunoassay (RIA), were found in 5.3%, but amniotic fluid chlamydial RIA IgA antibodies were almost absent. Serum IgG antibodies were measured with indirect immunofluorescence (IF). Of the mothers 9.8% had a titer greater than or equal to 1:64, correlating closely with the figure of 10.9% for infants' cord-blood IF serology. Finally, a case report is presented. A child born to a Chlamydia trachomatis positive mother developed isolation positive chlamydial pneumonia.     

衣原体感染与宫颈糜烂的关系及激光治疗效果

目的研究CT感染与宫颈糜烂的关系及激光治疗效果。方法PCR法检测472例患宫颈糜烂分泌物的沙眼衣原体DNA，并对激光治疗后疗效进行分析。结果宫颈糜烂患CTDNA检出率较正常健康妇女高，CT阳性患宫颈糜烂相对重，对激光治疗效果较无CT感染患差。结论衣原体感染为宫颈糜烂的一个重要原因，衣原体感染影响宫颈糜烂激光治疗效果，应重视对宫颈糜烂患衣原体感染的检查。     

AAUS guideline for chlamydial urethritis

Urogenital chlamydial infection is the most common sexually transmitted infection. Many cases of chlamydial infection are reported worldwide every year. Genital chlamydial infection in women can also cause obstetric issues, including infertility and miscarriage. For that purpose, appropriate care should be conducted with the latest knowledge.Only few guidelines come from Asian countries. The Asian Association of Urinary Tract Infection and Sexually Transmitted Infection (AAUS) belonging to the Urological Association of Asia (UAA) had developed the guidelines regarding chlamydial urethritis. We have collected the feedback and updated the guidelines which is now submitted for consideration of publication. In addition to the levels of evidence, the recommendation grades were defined using the modified GRADE methodology. Herein, we present the new edition of the UAA-AAUS guidelines for chlamydial urethritis.     

Autoprocessing and self-activation of the secreted protease CPAF in Chlamydia-infected cells

The Chlamydia-secreted protease/proteasome-like activity factor (CPAF) is synthesized as a proenzyme (proCPAF) and requires processing for proteolytic activity. Recent structural studies have further demonstrated that CPAF is a serine protease that can undergo autoprocessing and self-activation in a concentration-dependent manner in vitro. However, it is not known how CPAF is processed and activated during chlamydial infection. In the current study, we used a mutant CPAF designated as CPAF(E558A) that is deficient in processing by itself as a substrate to search for putative CPAF activation factor(s) in Chlamydia-infected cells. CPAF(E558A) was processed by the lysates made from Chlamydia-infected cells and the processing activity correlated with the presence of endogenous active CPAF in the fractionated lysate samples. CPAF produced in the Chlamydia-infected cells is required for processing the mutant CPAF(E558A) since the processing activity was removed by depletion with anti-CPAF but not control antibodies. Furthermore, a purified and activated wild type CPAF alone was sufficient for processing CPAF(E558A) and no other chlamydial proteases are required. Finally, fusion tag-induced oligomerization can lead to autoprocessing and self-activation of the wild type CPAF in mammalian cells. These observations together have demonstrated that CPAF undergoes autoprocessing and self-activation during chlamydial infection.     

抗肺炎衣原体蛋白酶样活性因子单克隆抗体在冠状动脉硬化患者肺炎衣原体感染诊断中的初步应用

目的 制备抗肺炎衣原体蛋白酶样活性因子重组蛋白的单克隆抗体,检测冠状动脉硬化患者的外周血单核细胞和冠状动脉瘤斑块中肺炎衣原体特异性抗原.方法 以肺炎衣原体蛋白酶样活性因子重组蛋白免疫小鼠,与SP2/0细胞融合后,采用间接ELISA和Western blot筛选阳性杂交瘤细胞,经亚克隆建株;小鼠体内诱生腹水法制备单克隆抗体,用硫酸铵沉淀法对腹水中的单克隆抗体进行纯化,测定其亚类和效价;检测肺炎衣原体标准株以鉴定其特异性.建立间接ELISA方法检测冠状动脉硬化患者外周血单核细胞和冠状动脉瘤斑块标本中的肺炎衣原体抗原.结果 获得4株稳定分泌抗蛋白酶样活性因子重组蛋白的杂交瘤细胞株,分别命名为3F8、7B9、8C4和11B5,其效价分别为1∶28000、1∶16000、1∶38000和1∶12000;经亚类鉴定,3F8和7B9杂交瘤细胞分泌的单克隆抗体为IgG2b,其它2株均为IgG1.以制备的单克隆抗体建立间接ELISA检测肺炎衣原体抗原,与经典PCR方法的检测结果比较,检出率具有较高的一致性.结论 成功获得了抗肺炎衣原体蛋白酶样活性因子重组蛋白的特异性单克隆抗体,能特异地识别天然肺炎衣原体蛋白酶样活性因子抗原,有望应用于冠状动脉硬化患者肺炎衣原体感染的抗原诊断.     

子宫颈衣原体和支原体感染与自然流产关系的临床探讨

目的探讨生殖道衣原体和支原体感染与胚胎停止发育之间的关系。方法收集78例胚胎停止发育的自然流产妇女（观察组）和65例正常早孕人工流产妇女（对照组）的宫颈分泌物进行解脲支原体（HU培养）和沙眼衣原体（cT）抗原检测,比较两组妇女支原体、衣原体感染的阳性率。结果观察组uu阳性34例,阳性率43．59％;CT阳性29例,阳性率37．17％,CT＋uu阳性18例,阳性率23．08％。对照组uu阳性7例,阳性率10．97％,CT阳性11例．阳性率16．92％,CT＋uu阳性4例,阳性率6．15％,差异明显（P〈0．01）。结论妇女生殖道uu和CT感染可能是胚胎停止发育的重要原因之一。     

Clinical presentations of chlamydial and non-chlamydial reactive arthritis

The aim of this study was to investigate the triggering micro-organisms and the clinical as well as laboratory differences between Chlamydial and non-chlamydial reactive arthritis (ReA) in a prospective study on 98 patients with acute/subacute arthritis. An inciting organism was found in 42 patients. Eighteen of these were chlamydial. Fifty-seven percent of all ReA patients were carriers for HLA-B27, which increased to 67% in the chlamydial group. Chlamydial ReA patients had more urethritis (P<0.05) with a longer period between arthritis and inciting infection, significantly lower CRP levels, and involved joint counts (P<0.05). Additionally, sacroiliitis was more frequent besides extra-articular manifestations in chlamydial ReA group. This study shows that chlamydial ReA differs in some points from non-chlamydial ReA, which in turn may affect the evaluation of an arthritic patient. ReA due to chlamydia more frequently encompasses a monoarticular or oligoarticular clinical picture with predominant distal extremity involvement. Non-chlamydial ReA presents higher joint counts and may involve upper extremity joints.