nemoci-sympt/BAKTERIALNI-INFEKCE/chlamydie/symptomy-a-asociovana-onemocneni/asociace
Persistent antibody positivity for C. pneumoniae
- Identification of the organism in different body sites
- Difficulty in obtaining effective clearance of the bacterium
- Hypothesis that may involved in maintaining or worsening of diverse chronic conditions [25]
Asociované choroby
Acute Fibrinous and Organizing Pneumonia (AFOP)
- Chlamydia pneumoniae association [130]
- Histologic pattern associated with a clinical picture of acute lung injury
- Differs from the classic presentations of
- Diffuse alveolar damage (DAD)
- Bronchiolitis obliterans with organizing pneumonia (BOOP),
- Eosinophilic pneumonia (EP) [130]
- AFOP can occur in an
- Idiopathic setting
- Association with a wide spectrum of clinical conditions [130]
- Dominant histological finding in AFOP
- Presence of intra-alveolar fibrin
- “fibrin balls” within the alveolar spaces [130]
- AFOP has a poor prognosis
- Overall mortality rate of about 50% [130]
- Four cases of C. pneumoniae infection associated with BOOP reported in the literature and this case
Casereport of Chlamydia pneumoniae infection associated with AFOP
- Respiratory failure
- Multi-organ dysfunction, and death
- A 69-year-old woman with a history of hypertension, type II diabetes mellitus and chronic liver disease
- Four-day history of arthromyalgias, rhinorrhea, dry cough, fever, and progressive shortness of breath
- no exotic travel or contact with animals
- Received the influenza vaccine annually and pneumococcal vaccine the previous year
- Usual treatment was an ACE inhibitor and glibenclamide
- At hospital admission:
- Tachypneic (32 breathsmin-1)
- Oxygen saturation was 92% breathing room air
- Blood pressure 120/60mmHg
- Pulse 111 beatsmin-1
- Axillary temperature 37.9°C
- Respiratory auscultation - crackles in both lower hemithoraces
- Room air arterial blood gas determination showed
- Acute respiratory hypoxia
- Arterial oxygen tension (PaO2) of 8.3kPa (62mmHg)
- Arterial carbon dioxide tension (PaCO2) of 2.7kPa (20mmHg)
- PH of 7.5
- Oxygen saturation of 95.4%
- Platelet count 34,000 cellsmm-3 (34.0 cells × 109·L-1)
- White blood cell count 3,900 cellsmm-3 (3.9 cells × 109·L-1) with 87% neutrophils
- Na+ 129 mmolL-1
- Chest radiography
- Alveolar consolidation in the right-middle and right-lower lobes
- Lingula
- A sputum sample could not be obtained
- Urinary antigen detection by immunochromatography
- Negative for both Legionella pneumophila and Streptococcus pneumoniae
- Diagnosis of community-acquired pneumonia
- Treated with
- Intravenous ceftriaxone (1g/day) and levofloxacin (500mg/day) for 24hours
- Followed by levofloxacin after establishing that urinary antigen for S. pneumoniae was negative
- During the following two days
- Clinical condition deteriorated
- Consolidation on chest radiograph progressed
- Respiratory failure ensued, requiring transfer to the intensive care unit
- Invasive mechanical ventilation
- Systemic corticosteroids
- Chest computed tomographic scan
- Areas of consolidation
- Ground glass opacities in the lower lobes
- Bronchoalveolar lavage studies were negative for
- Mycobacteria, fungi, conventional bacterial culture
- Adenovirus, Influenza, Respiratory Syncytial Virus, Herpes simplex 1/2, Cytomegalovirus and Varicella Zoster
- Transbronchial biopsy
- Inflammatory process
- Predominance of alveolar fibrin exudate in the form of “fibrin balls”
- Without formation of hyaline membranes [130]
- Signs of organization compatible with AFOP
- Immunology was negative for vasculitis
- Anti-proteinase 3, anti-myeloperoxidase, and anti-glomerular basement membrane antibodies [130]
- Echocardiography
- Good global contractility
- Pulmonary artery pressure
- Of 4.9kPa (37mmHg) [130]
- Respiratory distress and multiorgan dysfunction ensued and the patient died after 20 days of admission
- Autopsy was not performed because it was not authorized by the family
- Serologies for Mycoplasma pneumoniae, Coxiella burnetti and Legionella pneumophila were negative
- Chlamydia pneumoniae serology anti-IgG using
- Indirect microimmunofluorescence techniques (MIF, Focus Diagnostics)
- Enzyme immunoassay (EIA, Savyon Diagnostics)
- Showed a four-fold rise in IgG titers (1:32-1:512) between the first and second serum samples extracted 13 days apart
- IgM detection was inconclusive by EIA [130]
Ankylosing spondylitis
- Feng et al, 2011 [153]
Bronchogenní karcinom
Cross-reactive (auto)antibodies
- Chlamydia pneumoniae (CPP)
- Streptococcal M protein (STM6P)
- Milk butyrophilin (BTN)
- Versus neuron-specific antigens in autism (Vojdani et al, 2002) [153]
Erythema nodosum
- [121]
Giant cell arteritis (GCA)
- Dendritické buňky inf. Chl. pneumonia in temporal artery biopsies [12]
Guillain-Barré syndrome
- One case of has been described (Haidl et al., 1992) [151]
Iritida
- [121]
Non-hodgkinský lymfom
- [121]
Reactive arthritis
- Bolesti kolen, které vznikly cca po několika letech od chlamydiové faryngitidy a následně neuspěšně léčeném postinfekčním astma bronchiale [7]
- Píchavá bolest opakující se při pohybu ve stejných místech kloubu
- Velmi pomalá progrese
- V klidu studené klouby, po pohybu přehřáté, žhutí
- Zvýšené ochlupení kolen
- člověk časem chodí opatrně, bojí se našlapovat neopatrně, aby nevyvolal bolest v kloubu
- Nedělá dřepy, pak omezuje schody, neběhá
- Následně má strach, že žádný sport již není pro něho
- Vše probíhá plíživě, v člověk roste sugesce, že klouby jsou unavené a poškožené - artroza
- žádný otok, žádný hnis, žádné krystalky, žádné zjevné příčiny
- Jak jdou roky, další obtíže v krční páteři a jiných kloubech
- Všechny obtíže zmizí do 2 dnů po zahájení terapie Azitromycinem jak mávnutím proutku
Reiter's syndrome
- Evaluated (Braun J et al., 1994) [151]
Sarkoidóza
Sweet’s syndrom
- Akutní neutrofilní dermatóza [121]
Syndrom Sézary
- Maligní T lymfom s erytrodermií
- Generalizovanou lymfadenopatií
- Leukemizací periferní krve [121]
Acne rosacea
- Chlamydia pneumoniae in the etiology and response to the use of oral azithromycin.
- Fernandez-Obregon A1, Patton DL.
- Chronic skin disorder
- Requires long-term therapy
- Oral azithromycin has been used successfully to treat acne vulgaris
- Adults (not previously reported) with acne rosacea were selected to be treated with oral azithromycin
- Nine of the 10 subjects received 250 mg 3 times weekly for periods ranging from 5 to 19 weeks
- Follow-up examinations were performed on 8 of the 9 treated subjects
- C pneumoniae antigen was detected in malar biopsy specimens in 4 of 10 subjects by immunoperoxidase technique (using monoclonal antibody to C pneumoniae)
- Serum antibodies against C pneumoniae were detected in 8 of 10 intent-to-treat subjects.
- Using polymerase chain reaction, C pneumoniae was not detected in peripheral blood mononuclear cells
- Inflammatory response in tissues
- Widespread infiltration of polymorphonuclear neutrophil cells, lymphocytes, and plasma cells
- Which support the clinical diagnosis of acne rosacea
- Nine of 10 subjects treated with azithromycin
- Moderate to marked improvement of their acne rosacea
- No adverse reactions to azithromycin occurred
PMID: 17388221 www.ncbi.nlm.nih.gov/pubmed/17388221
Acne rosacea
- Chronic inflammatory skin disorder rosacea
- May have a slightly increased risk of dementia, including Alzheimer’s disease
- Both conditions have elevated expression of certain proteins
Scientists at the University of Copenhagen
- Adult Danish population between 1997 and 2012, which was about 5.6 million people
- About 82,400 of those patients had rosacea.
- 2012, researchers analyzed the study group’s death rates, causes of death, and incidences of dementia diagnoses
- About 99,000 people had developed dementia, of which about 29,000 had Alzheimer’s.
- Rosacea patients had
- 7 % increased risk of dementia
- 25 % increased risk of Alzheimer’s disease
- Compared with those who didn’t have the skin condition
- Women with rosacea
- 28 % increased risk of Alzheimer’s
- Men with rosacea
- 16 % increased risk of Alzheimer’s
- Stratified their results by age at study entry
- Alzheimer’s risk was only significantly elevated among individuals who were 60 years old
- 20 % increased risk
- Restricted to patients whose rosacea diagnoses came from a hospital dermatologist
- Heightened risks of Alzheimer’s and dementia were 92 % and 42 %, respectively !!!
- Link between rosacea and neurological diseases
- Subtype of rosacea patients have prominent neurological symptoms such as
- Burning and stinging pain in the skin
- Migraines
- Neuropsychiatric symptoms
- Certain mechanistic overlaps between rosacea and Alzheimer's disease
Možná není tak uplně náhoda, že Akne rosacea i Alzheimerova jsou obojí asociovány s infekcí Chlamydia pneumonia
- www.foxnews.com/health/study-links-rosacea-with-increased-risk-of-alzheimers-disease
- [121]
- Séropozitivita proti Hsp60 C. pneumoniae a elevované titry protilátek zvyšují signifikantně riziko pro následný vznik plicní rakoviny [121]
- Podporuje roli C. pneumoniae v karcinogenezi [121]
- Zvýšená mazotvroba - "mastný pot"
- Popisováno u Chlamydia trachomatis při eskalace infekce, která může být jina asymptomatická
- "more sebum production as the infection escalates, all which produces greasy sweat, more oily complexion, and can be misdiagnosed as acne eruptions rather than the whole body's hidden fight to defend itself from an STD" en.wikipedia.org/wiki/Chlamydia_(genus)
- Obdobne symptomy se popisují při incipientnich stadiich Alzeimerovy choroby / Parkinsonovy choroby
- Pokud tohle umí Chlamydia trachomatis, možná totéž bude umět i Chlamydia pneumonia ?
- Po krátkém prvotním hledání jsem našla, že Chlamydia pneumonia je asocioavaná s akne a akne rosacea = asi by tedy mohla umět i zvýšenou mazotvrobu
- Infikované monocyty umožní Chlamydii pronikat hematoencefalickou bariérou [121]
- Infekce C. pneumoniae asoc. s akutním postižením centrální nervové soustavy typu
- Meningoencefalitidy
- Syndromu Guillain-Barré
- Role u
- Sklerózy multiplex (SM)
- Může být pouze oportunní sekundární událostí
- Přítomnost tohoto patogenu může vést k exacerbaci či modulovat již preexistující patologický proces
- Nemocní s C. pneumoniae PCR-pozitivním mozkomíšním mokem mají více aktivní léze než nemocní s negativním nálezem [121]
- Alzheimerovy nemoci [121]
- 2 cases, responded well to antimicrobial treatment [Unpublished data] [48]
- Carter et al, 2011 [153]
- Arias et al, 2012 [153]
- Séropozitivita proti Hsp60 C. pneumoniae a elevované titry protilátek zvyšují signifikantně riziko pro následný vznik plicní rakoviny [121]
- Podporuje roli C. pneumoniae v karcinogenezi [121]
- [121]
