Chlamydia

Sources/Clones
American Research Products (C512F), American Research Products/EY Labs (polyclonal), Biogenex (LM-9, 16-UB), Dako (RR402) and Fitzgerald (polyclonal).

C. Trachomatis
Accurate (115), Biogenesis (polyclonal), Biodesign (168, JDC1), Pharmingen (CHL888). Biokit, Barcelona, Spain and Syva Micro Trak, Palo Alto, CA.

C. Trachomatis 60 kD
Biodesign (168) and Biogenesis (polyclonal).

C. Psittaci
Biogenesis (73-0200, 77-05) and Kallestadt Diagnostics, Chaska, MN.

Fixation/Preparation
Most antibodies are applicable to routine formalin-fixed, paraffin-embedded tissue.

Background
Genital chlamydial infection is recognized as the world's most common sexually transmitted disease (WHO, 1990). In the majority of cases the condition is asymptomatic.C. trachomatis is associated with various complications of pregnancy (Lan et al, 1995), premature birth and neonatal difficulties (Donders et al, 1991; Gencay et al, 1995). A monoclonal antibody specific for the outer membrane proteins of C.trachomatis is available.
C. psittaci is the causative agent of psittacosis. It infects a diverse group of animals, including birds, humans and other mammals. It is a cause of abortion in sheep, cattle and goats (Schlossberg, 1995). Transmission to humans is incidental, with a history of direct contact with contaminated products of conception. The disease is characterized as a mild-to-moderate flu-like illness (Gherman et al, 1985). However, in pregnancy the human host is especially vulnerable. Gestational psittacosis typically presents as a progressive febrile illness with headaches, complicated by abnormal liver enzymes, low-grade disseminated intravascular coagulopathy, atypical pneumonia and abnormal renal function (Hyde & Benirschke, 1997). Management includes termination of pregnancy with aggressive antibiotic therapy (Khatib et al, 1995).

Applications
Diagnosis of gestational psittacosis is dependent on histopathological findings which consist of an intense acute intervillositis, perivillous fibrin deposition with villous necrosis and large irregular basophilic intracytoplasmic inclusions within the syncytiotrophoblast (Wong et al, 1985).The application of genusspecific monoclonal antichlamydial antibody is useful for the rapid confirmation of the diagnosis (Mahoney et al, 1987).
C.trachomatis is a major cause of genital infection. The acquired infection tends to persist and is usually symptom free (Beatty et al, 1994). Consequently fetal exposure to chlamydial infection is high, with C.trachomatis being demonstrated in the placenta (Gencay et al, 1997). More often, basophilic intracytoplasmic inclusions are detected in cervical smears, where genus-specific antibody may be applied for diagnostic confirmation. In lymphogranuloma venereum, a small ulcerating primary lesion develops in the genitalia, followed by involvement of draining lymph nodes with a suppurative granulomatous inflammation, necrosis and scarring. develops in the genitalia, followed by involvement of draining lymph nodes with a suppurative granulomatous inflammation, necrosis and scarring.
Inclusion bodies may also be demonstrated in lung tissue and secretions in atypical pneumonias caused byC.trachomatis. Trachoma/trachoma inclusion conjunctivitis or TRIC infection is common in the tropical zones, being responsible for blindness. The organism initially infects the conjunctival epithelium and it can be demonstrated in smears of these cells by the presence of characteristic intracytoplasmic inclusion bodies.

References
•Beatty WL, Morison RP, Byrne GI 1994 Immunoelectron microscopic quantitation of differential levels of chlamydial proteins in cell culture model of persistent Chlamydia trachomatis infection. Infection and Immunology 62: 4059-4062.

•Donders GG, Moerman P, De-Wet GH et al 1991 The association between Chlamydia cervicitis and neonatal complications. Archives of Gynecology and Obstetrics 249: 79-85.

•Gencay M, Koskiniemi M, Saikku P et al 1995.C trachomatis seropositivity during pregnancy is associated with perinatal complications. Clinical Infectious Disease 21: 424-426.

•Gencay M, Puolakkainen M, WahlstrÝ T et al 1997. Chlamydia trachomatis detected in human placenta. Journal of Clinical Pathology 50:852-855.

•Gherman RB, Leventis LL, Miller RC 1985 Chlamydial psittacosis during pregnancy: a case report. Obstetrics and Gynecology 86: 648-650.

•Hyde SR, Benirschke K 1997 Gestational Psittacosis: Case report and literature review. Modern Pathology 10: 602-607.

•Khatib R, Muthayipalayam C, Thirumoorthi MC et al 1995 Severe psittacosis during pregnancy and suppression of antibody response with early therapy. Scandinavian Journal of Infectious Disease 27: 519-521.

•Lan J, Van Der Brule AJ, Hemrika DJ et al 1995 Chlamydia trachomatis and ectopic pregnancy: retrospective analysis of salpingectomy specimens, endometrial biopsies, and cervical smears. Journal of Clinical Pathology 48: 815-819.

•Mahoney JB, Sellors J, Chernesky MA 1987 Detection of Chlamydial inclusions in cell culture or biopsy tissue by alkaline phosphatase-anti-alkaline phosphatase staining. Journal of Clinical Microbiology 25: 1864-1867.

•Schlossberg D 1995 Chlamydia psittaci(psittacosis). In: Mandell G, Bennet J, Dolin R (eds). Principles and practice of infectious diseases, 4th edn. New York: Churchill Livingstone, pp 1693-1695.

•WHO 1990 Guidelines for the prevention of genital chlamydial infections. Copenhagen: World Health Organization Regional Office for Europe.

•Wong SY, Gray ES, Buston D et al 1985. Acute placentitis and spontaneous abortion caused by Chlamydia psittaciof sheep origin: a histological and ultrastructure study. Journal of Clinical Pathology 38: 707-711.

Bibliografía
Manual of diagnostic antibodies for immunohistology / Anthony S.-Y. Leong, Kumarasen Cooper, F. Joel W.-M. Leong.