title: Chlamydia pneumoniae in patients undergoing surgery for thoracic aortic disease.
abstract: OBJECTIVE
  To investigate if Chlamydia pneumoniae is present in the wall of the thoracic aorta in patients operated on for aneurysm or aortic dissection.
  
  
  METHODS
  Consecutive patients undergoing surgery for thoracic aortic aneurysm (TAA, 32 patients) and for aortic dissection (6 patients) were included in this prospective study. Tissue samples from the aorta were analysed for the presence of C. pneumoniae by polymerase chain reaction (PCR), histopathology, immunohistochemistry and in one aortic tissue sample C. pneumoniae was verified by electron microscopy and immunogold labelling technique. Cultured Hep 2 cells infected with C. pneumoniae were used as a positive control for electron microscopy. Sera for microimmunofluorescence were obtained in 36/38 and throat swabs for C. pneumoniae PCR in 17/38 patients.
  
  
  RESULTS
  Chlamydia pneumoniae was detected by PCR in 4 of 32 TAA tissue samples (12%) and in 0 of 6 patients operated on for aortic dissection. Chlamydia pneumoniae inclusion bodies in one of the PCR positive tissue samples were verified by electron microscopy. IgG antibodies to C. pneumoniae were present in 17/31 (55%) and IgA in 15/31 (48%) of the TAA patients and in none of five tested patients with dissection. None of the tested throat swabs was positive.
  
  
  CONCLUSIONS
  In this study we report the presence of C. pneumoniae by PCR and electron microscopy in the wall of TAA. A high prevalence of serum IgA antibodies to C. pneumoniae was found in TAA patients. In contrast no signs of C. pneumoniae were detected in patients with thoracic aortic dissection.
authors.affiliation: Section of Infectious Diseases, Uppsala University Hospital, SE-75185 Uppsala, Sweden. Christina.Nystrom-Rosander@medsci.uu.se
authors.forename: Christina
authors.initials: C
authors.lastname: Nyström-Rosander
authors.forename: Eva
authors.initials: E
authors.lastname: Hjelm
authors.forename: Agneta
authors.initials: A
authors.lastname: Lukinius
authors.forename: Göran
authors.initials: G
authors.lastname: Friman
authors.forename: Lars
authors.initials: L
authors.lastname: Eriksson
authors.forename: Stefan
authors.initials: S
authors.lastname: Thelin
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D002690:Chlamydia Infections / Q000150:complications* / Q000175:diagnosis; D016993:Chlamydophila pneumoniae / Q000302:isolation & purification*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity