15 1 Vol. 15 No Journal of Medical Postgraduates Feb (MIF) IgG IgM IgA PBMC. npcr (36. 5 % %, P < 0. 01) 84.

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1 Vol. 15 No Journal of Medical Postgraduates Feb ( ) : : (npcr) (PBMC) DNA : npcr PBMC DNA (MIF) IgG IgM IgA : PBMC npcr (36. 5 %12. 2 % P < 0. 01) %PBMC npcr IgG PBMC npcr (52. 5 %) (44. 4 %) (39. 4 %) (33. 3 %) (28. 8 %) : npcr : ; ; ; ; : R37413 : A : (2002) Ξ Clinical stydy on detection of chlamydia pneumoniae DNA in peripheral blood mononulcear cells by nested ploymerase chain reaction in patients with respiratory tract infection WEI Dong SHI Yi ZHAO Bei2lei FENG Gen2bao XIN Xiao2feng ( Deparment of Respiratory Diseases Jinling Hospital Nanjing Jiangsu China) Abstract : Objectives : To investigate persistent infection of Chlamydia pneumoniae (C. pneumoniae) in pa2 tients with respiratory tract infection and the value of blood2based nested polymerase chain reaction(npcr) in diagnosing persistent infection of C. pneumoniae. Methods :A prospective study for C. pneumoniae infectin was conducted in 137 patients with respiratory tract infection from August 2000 to February 2001 and 74 healthy volunteers as controls were also examined. The presence of infection was investigated by npcr for C. pneumoniae DNA from peripheral blood mononuclear cells ( PBMC) specimens and microimmunofluorescence (MIF) testing for C. pneumoniae2specific IgGIgM and IgA antibodies. Results :Prevalence of C. pneumoni2 ae DNA in PBMC in patients with respiratory tract infection was higher than that of healthy volunteers(36. 5 % vs % P < 0. 01). C. pneumoniae2specific MIF serology confirmed exposure to the bacterium in 41(82 %) of the 50 npcr2positive patients and all of the npcr2positive volunteers were positive by C. pneumoniae2spe2 cific serology. The npcr2positive rate was % in asthma patients % in acute bronchitis % in chronic obstructive pulmonary disease % in bronchiectasis and % in pneumonia. Conclusions : C. pneumoniae may be hardored in human monocytes and become persistent infection. The persistent infection of C. pneumoniae may be related with episodes of asthma exacerbations of COPD and it may be associated with Ξ : ; : : (19762)

2 pneumonia and bronchitis. Since conventional diagnostic methods are of limited value on identifying patients with persistent infection detection of C. pneumoniae DNA in PBMC by npcr may prove a useful means of di2 agnosing persistent infection of C. pneumoniae. Key words : Peripheral blood mononuclear cells ; Nested polymerase chain reaction ; Chlamydia pneumo2 niae ; Persistent infection ; Respiratory tract infection 0 2 ml ; PBMC : 50 % 10 ml 1 IgG PBMC npcr g 2 / d ; npcr PBMC (npcr) DNA ( PBMC) : DNA (MIF) IgG IgM IgA 1 (CWL ) 111 Dako : : IgG 2 () IgM 4 4 ; IgM ;IgG : IgA ( ) : IgG < IgM < 1 16 IgA < IgM Elisa (COPD) : ; npcr :10 ml ; ; EDTA 10 ml ( ) ; 10 ml ( ) PBMC DNA : UNIQ210 DNA ( ) PBMC ( ) DNA npcr : npcr ( ) 3 npcr 2 % bp P < P < (RF) (CMV) PBMC npcr :

3 IgG IgG ( 1 16) % (113/ 137) ( % 59/ 74) ( P > 0. 05) % ( 23/ 137) (6. 8 % 5/ 74) ( P < 0. 05) % ( 23/ 137 ) 50 PBMC npcr 24 (13. 5 % 10/ 74) ( P > 0. 05) (48 %) 212 PBMC npcr CMV PBMC npcr 213 PBMC npcr PBMC npcr 50 npcr ( P < 0. 01) 41 (82 %) IgG ( ) ; 9 npcr IgG % (50/ 59) PBMC ( P < 0. 05) 1 npcr IgG ( 3) PBMC npcr 1 PBMC npcr Table 1 Results of CP npcr test of PBMC in patients with respira2 tory tract Infection compared with health volunteers n n ( %) P < ; 3 3 P < PBMC npcr % (28/ 67) ;30 PBMC npcr % (16/ 45) ; % (6/ 25) 2 PBMC npcr Table 2 Results of the CP npcr test of PBMC in different respira2 tory illness n n ( %) COPD (1 16 IgG < 1 512) % (45/ 59) ( IgG 1 512) 815 %(5/ 59) ( P < 0. 01) 3 PBMC npcr Table 3 Findings of CP DNA in PBMC by npcr in relation to CP specific serology by MIF npcr + npcr - npcr + npcr - IgG IgG npcr PBMC 23 ( IgG IgM npcr PBMC 1 32) 7 npcr % npcr 20 %(1/ 5) COPD npcr (2) 41 (1 16 IgG< 1

4 IgM < 1 16 IgA < 1 16) 7 PCR 37 npcr 9012 % Boman %(8/ 56) ( P < 0. 01) npcr 46 % : Boman 23 ( IgA 1 16) ; 12 npcr 52 % ; 60 %(6/ 10) PBMC npcr (52. 5 %) PBMC 3 3 (44. 4 %) (39. 4 %) 3 2 ; (33. 3 %) (28. 8 %) COPD 2IgE ; Hammerschlag PBMC npcr 24 (48 %) PBMC npcr 4 PBMC DNA 5 PBMC DNA PBMC npcr 137 PBMC npcr 3615 % % ; % 59 % PBMC npcr COPD % (50/ 59) npcr npcr PBMC PBMC DNA % PBMC Moazed 4 PBMC PBMC DNA Sari 6 DNA mrna PBMC DNA

5 1 21 M. PBMC DNA PBMC mrna Ward 10 npcr PBMC DNA : : Wang SP. The microimmunofluorescence test for Chlamydia pneumoni2 ae infection :technique and interpretationj. J Infect Dis (Suppl 3) :S4212S Hammerschlag MR Chirgwin KRoblin PM et al. Persistent infection with Chlamydia pneumoniae following acute respiratory illnessj. Clin Infect Dis (1) : Moazed TC Kuo CC Grayston JT et al. Evidence of systemic dissem2 ination of Chlamydia pneumoniae via macrophages in the mousej.j Infect Dis : Boman J Soderberg S Forsberg J et al. High prevalence of Chla2my2 dia pneumoniae DNA in peripheral blood mononuclear cells in patients with cardiovascular disease and in middle2aged blood donorsj.j In 2 fect Dis : Sari Airenne Heljg2Marja Surcel Hannu Alakgrppg et al. Chla2mydia pneumoniae Infecton in Human MonocytesJ. Infection and Immuni 2 ty (3) : Niedzwiadek J Mazur E Chmielewska2Badora J et al. Chronic Chlamydia pneumoniae infection in patients with asthmaj. Pneu 2 monol Alergol Plo (526) : Mazur E Niedzwiadek J Chmielewska2Badora J et al. Chronic Chlamydia pneumonia infection in patients with chronic obstructive pulmonary diseasej. Pnuemonol Alergol Pol (526) : Gieffers J Fullgraf H Jahn J et al. Chlamydia pneumoniae infection in circulating human monocytes is refractory to antibiotic treatment J. Circulation (3) : Michael E. Ward. Mechanisms of Chlamydia2Induced Disease. In : S. stephens ed. Chlamydia Intracellular Biology Pathogenesis and Im2 munitym. Richard ASM PRESS NEW YORK :. ( ) ( ) : ; : R644 : A : (2002) h g > 30 % > 50 %86 > 80 %44 4 ( 24 )

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