Alison L. Cappuccio

Detection of Chlamydia trachomatis in fallopian tube tissue in women with postinfectious tubal infertility

OBJECTIVE Biopsy tissues from women with postinfectious tubal infertility were studied for the presence of Chlamydia trachomatis. STUDY DESIGN Tubal biopsy specimens from 25 women with postinfectious tubal infertility undergoing laparoscopy for repair of fallopian tubes were evaluated by culture, in situ hybridization. Immunocytochemistry, and transmission electron microscopy for the presence of Chlamydia trachomatis. Serum was also tested for Chlamydia trachomatis antibodies. RESULTS Chlamydia trachomatis was detected in postinfectious tubal biopsy specimens in three of 25 patients by culture, 12 of 24 by in situ hybridization, 15 of 22 by immunoperoxidase stain, and two of 10 by transmission electron microscopy. Serum antibody against Chlamydia trachomatis was detected in 15 of 21 patients. CONCLUSION Chlamydia trachomatis deoxyribonucleic acid or antigens were detected at a high percentage (19/24 women) in the biopsy tissues of the fimbrial and peritubal adhesions by in situ hybridization or immunoperoxidase stain, suggesting a persistent infection in these women even after antibiotic treatment.

Detection of Chlamydia pneumoniae in atherosclerotic plaques in the walls of arteries of lower extremities from patients undergoing bypass operation for arterial obstruction

PURPOSE To study surgically excised vascular tissue from lower extremities for the presence of Chlamydia pneumoniae, to extend the previously described association of the organism with atherosclerosis. METHODS Arterial biopsy specimens obtained from femoral and popliteal arteries during bypass operation for claudication were examined by immunocytochemical analysis and polymerase chain reaction for the presence of organisms. RESULTS C. pneumoniae was detected in atherosclerotic plaques by either method in either artery of 11 of 23 patients (48%). Eight of 21 popliteal and three of 18 femoral arteries had positive results. CONCLUSIONS Detection of C. pneumoniae in peripheral arteries indicates that the organism is widespread in atherosclerosis of the vascular system.

Detection of Chlamydia trachomatis deoxyribonucleic acid in women with tubal infertility

Objective To determine the presence of Chlamydia trachomatis by in situ hybridization in fallopian tube tissues of women with distal tubal occlusion. Patients Subjects were selected from a Seattle-based study of infertility in women with distally occluded fallopian tubes undergoing reconstructive surgery. For comparison, six specimens were obtained from women undergoing surgery for noninfertility-related conditions who had normal appearing tubes. Methods Tissue specimens from 16 of these patients were selected for analysis by in situ hybridization and immunoperoxidase (IP) staining. Results C . trachomatis was detected in 9 of 16 women by either in situ hybridization or IP. Six of the nine were seropositive with titers ranging from 1:16 to 1:64. Tissue from 6 women with normal appearing fallopian tubes were negative by in situ hybridization. Conclusions The demonstration of C . trachomatis deoxyribonucleic acid and/or antigens in fallopian tube tissue from infertile women with distal tubal disease suggests that C. trachomatis can persist in these tissues in an uncultivable state.

Detection of Chlamydia trachomatis deoxyribonucleic acid in monkey models (Macaca nemestrina) of salpingitis by in situ hybridization : implications for pathogenesis

OBJECTIVE Our purpose was to determine whether Chlamydia trachomatis persists in tubal tissues from monkey pocket models of chlamydial salpingitis and tubal infertility and to relate its presence to disease progression and histopathologic mechanisms. STUDY DESIGN In situ hybridization was used to detect Chlamydia deoxyribonucleic acid in a monkey pocket model of salpingitis and in the direct tubal inoculation monkey model of tubal infertility. Results were correlated with culture and immunocytochemistry results and histopathologic characteristics. RESULTS Chlamydia deoxyribonucleic acid was detected in the mucosa, submucosa, and deep tissues in the pocket model. In addition, it was present in peritubal adhesions from the direct inoculation model. Deoxyribonucleic acid was found at sites of inflammation and when culture and immunocytochemistry studies were negative. CONCLUSION The presence of Chlamydia trachomatis deoxyribonucleic acid at sites of inflammation and tissue damage in monkey models of chlamydial salpingitis and tubal infertility suggests that Chlamydia persists and may be directly involved in the stimulation of the immune-mediated tissue destruction associated with Chlamydia trachomatis infections.

Specificity of Detection of Chlamydia pneumoniae in Cardiovascular Atheroma

Chlamydia pneumoniae is commonly detected in atherosclerotic plaque but the frequency of detection in non-cardiovascular (CV) tissues has not been well determined. In this study, archival autopsy tissue specimens from both CV and non-CV sites from 38 patients were tested by polymerase chain reaction and immunocytochemistry to detect C. pneumoniae. In addition, 33 surgical granuloma biopsy specimens were also tested. C. pneumoniae was detected most frequently in coronary artery tissue (34%) but was also detected in specimens from lung (13%), liver (10%), spleen (5%), bone marrow (10%), and lymph node (8%). The organism was detected in 3 of 33 granuloma specimens. These findings suggest that C. pneumoniae demonstrates a tropism for CV tissues and is either not widely distributed to non-CV tissues or does not persist chronically in those tissues after initial infection.